What is pemetrexed?

Pemetrexed works as an antifolate. It interferes with the folate metabolism in the body, and thus inhibits the synthesis of folate-dependent enzymes which are needed for the formation of some nucleotides, the precursors of the genetic material. By preventing the formation of these nucleotides, the drug prevents the formation of the genetic material (DNA and RNA) required for the growth of both normal and cancer cells. Pemetrexed is administered as a solution via injection into a vein and is usually given once every 21 days. It is available in 500 mg vials of lyophilized powder. Known side effects include nausea and vomiting, fatigue, shortness of breath, anorexia, anemia, chest pain, fever, infection, edema, and rash.

Pemetrexed as a single-agent is indicated for the treatment of patients with locally advanced or metastatic non-small cell lung cancer after prior chemotherapy. The effectiveness of Pemetrexed in second-line NSCLC was based on the surrogate endpoint, response rate. There are no controlled trials demonstrating a clinical benefit, such as a favorable survival effect or improvement of disease-related symptoms.

Pemetrexed in combination with the chemotherapy agent cisplatin is used in treatment of malignant pleural mesothelioma when the disease is unresectable or somehow not a good candidate for surgery.