Pemetrexed therapy for malignant pleural mesothelioma.
OBJECTIVE
To review pemetrexed, a novel multi-targeted antifolate agent.


METHODS
A literature search was conducted (1985-September 2004) using MEDLINE and CANCERLIT. Recent abstracts from the American Society of Clinical Oncology were also included, along with the manufacturer's information. Key words were pemetrexed, LY-231514, Alimta, multi-targeted antifolate, malignant pleural mesothelioma.


METHODS
Relevant information on pharmacology, pharmacokinetics, and safety and efficacy of pemetrexed from clinical trials was selected.


RESULTS
Pemetrexed inhibits folate metabolism and purine/pyrimidine synthesis. Based on Phase I and II trials, pemetrexed has antitumor activity in solid tumors such as lung, colorectal, and cervical. A pivotal Phase III study in patients with malignant pleural mesothelioma (MPM) demonstrated survival superiority of pemetrexed-cisplatin regimen versus cisplatin.


CONCLUSIONS
Pemetrexed is a promising new drug for the treatment of solid malignancies, most notably MPM.
Puto
Katarzyna
K
Inpatient Oncology/Hematology, Pharmacy Department, Jackson Memorial Hospital, Miami, FL, USA.
Garey
Jody S
JS
D000964:Antimetabolites, Antineoplastic / Q000493:pharmacokinetics / Q000627:therapeutic use; D015507:Drugs, Investigational / Q000493:pharmacokinetics / Q000627:therapeutic use; D005971:Glutamates / Q000493:pharmacokinetics / Q000627:therapeutic use*; D006147:Guanine / Q000031:analogs & derivatives* / Q000493:pharmacokinetics / Q000627:therapeutic use*; D006801:Humans; D008654:Mesothelioma / Q000188:drug therapy* / Q000378:metabolism; D000068437:Pemetrexed; D016066:Pleural Effusion, Malignant / Q000188:drug therapy* / Q000378:metabolism; D010997:Pleural Neoplasms / Q000188:drug therapy* / Q000378:metabolism
D000964:Antimetabolites, Antineoplastic; D015507:Drugs, Investigational; D005971:Glutamates; D000068437:Pemetrexed; D006147:Guanine