Pemetrexed

Product Description

Pemetrexed (brand name Alimta) is a chemotherapy drug manufactured and marketed by Eli Lilly and Company. Its indications are the treatment of pleural mesothelioma and non-small cell lung cancer.

Medical use

In February 2004, the Food and Drug Administration approved pemetrexed for treatment of malignant pleural mesothelioma, a type of tumor of the lining of the lung, in combination with cisplatin^[1] for patients whose disease is either unresectable or who are not otherwise candidates for curative surgery.^[2] In September 2008, the FDA granted approval as a first-line treatment, in combination with cisplatin, against locally advanced and metastatic non-small cell lung cancer (NSCLC) in patients with non-squamous histology.^[3][4][5] A Phase III study showed benefits of maintenance use of pemetrexed for non-squamous NSCLC.^[6] Activity has been shown in malignant peritoneal mesothelioma.^[7] Trials are currently testing it against esophagus and other cancers.

Carboplatin

Pemetrexed is also recommended in combination with carboplatin for the first-line treatment of advanced non-small cell lung cancer.^[8] However, the relative efficacy or toxicity of pemetrexed-cisplatin versus pemetrexed-carboplatin has not been established beyond what is generally thought about cisplatin or carboplatin doublet drug therapy^[9]

Supplementation

Patients should take folic acid and vitamin B₁₂ supplement even if levels are normal when they are on pemetrexed therapy.^[10][11] (In clinical trials for mesothelioma, folic acid and B12 supplementation reduced the frequency of adverse events.) It is also recommended for patients to be on a steroid (e.g., dexamethasone 4 mg twice daily) on the day prior, day of, and day after Pemetrexed infusion to avoid skin rashes.^[12]