Pemetrexed Alone and in Combination with Platinum Compounds in the Management of Malignant Mesothelioma

Pemetrexed Therapy for Malignant Pleural Mesothelioma

OBJECTIVE:

To review pemetrexed, a novel multi-targeted antifolate agent.

DATA SOURCES:

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.

STUDY SELECTION AND DATA EXTRACTION:

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

DATA SYNTHESIS:

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.