Onkológia 4/2009

Pemetrexed - antifolate cytostatic drug for treatment of malignant pleural mesothelioma and non-small cell lung cancer

Pemetrexed, a pyrriol (2,3-d) pyrimidine antifolate, is unique among the folate antagonists in that it is a powerful inhibitor of not only thymidylate synthase (TS) but also dihydrofolate reductase (DHFR) and the purine synthetic enzyme, glycinamide ribonucleotide formyltransferase (GARFT). Pemetrexed is indicated in combination with cisplatin for the treatment of patients with malignant pleural mesothelioma whose disease is unresectable or who are otherwise not candidates for curative surgery. Pemetrexed is indicated in combination with cisplatin therapy for the initial treatment of patients with locally advanced or metastatic nonsquamous non-small cell lung cancer, for the maintenance treatment of patients with locally advanced or metastatic nonsquamous non-small cell lung cancer whose disease has not progressed after four cycles of platinum-based first-line chemotherapy and as a single-agent for the treatment of patients with locally advanced or metastatic nonsquamous non-small cell lung cancer after prior chemotherapy.

Keywords: pemetrexed, pyrimidine antifolate, malignant pleural mesothelioma, non-small cell lung cancer