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Wikipedia - Pemetrexed

Pemetrexed
Systematic (IUPAC) name
(S)-2-[4-[2-(4-amino-2-oxo-3,5,7-triazabicyclo[4.3.0] nona-3,8,10-trien-9-yl)ethyl] benzoyl] aminopentanedioic acid
Identifiers
CAS number 137281-23-3
ATC code L01BA04
PubChem CID 60843
DrugBank APRD00573
Chemical data
Formula C20H21N5O6 
Mol. mass 427.411 g/mol
Pharmacokinetic data
Bioavailability NA
Protein binding 81%
Metabolism Negligible
Half-life 3.5 hours
Excretion Renal
Therapeutic considerations
Licence data

EU EMA:link, US FDA:link
Pregnancy cat. D(US)
Legal status POM (UK) ?-only (US)
Routes Intravenous

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

Contents

[edit] History

The molecular structure of pemetrexed was developed by Edward C. Taylor at Princeton University and clinically developed by Indianapolis based drug maker, Eli Lilly and Company in 2004.

[edit] Mechanism of action

Pemetrexed is chemically similar to folic acid and is in the class of chemotherapy drugs called folate antimetabolites. It works by inhibiting three enzymes used in purine and pyrimidine synthesis—thymidylate synthase (TS), dihydrofolate reductase (DHFR), and glycinamide ribonucleotide formyltransferase[1][2] (GARFT). By inhibiting the formation of precursor purine and pyrimidine nucleotides, pemetrexed prevents the formation of DNA and RNA, which are required for the growth and survival of both normal cells and cancer cells.

[edit] Clinical 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. In September 2008, the FDA granted approval as a first-line treatment, in combination with cisplatin, against of locally-advanced and metastatic non-small cell lung cancer, or NSCLC, in patients with non-squamous histology[3]. A Phase III study showed benefits of maintenance use of pemetrexed for non-squamous NSCLC[4]. Trials are currently testing it against esophagus and other cancers.

[edit] Carboplatin

Pemetrexed is also recommended in combination with carboplatin for the first-line treatment of advanced non-small cell lung cancer[5]. 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[6]

[edit] Supplementation

Patients are required to be on folic acid and vitamin B12 supplementation when they are on pemetrexed therapy[7]. (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 4mg twice daily) on the day prior, day of, and day after Pemetrexed infusion to avoid skin rashes[8].

[edit] Side effects

Pemetrexed, whether used alone or in combination with cisplatin, has these side effects[9]:

[edit] External links

[edit] References

  1. ^ McLeod, Howard L.; James Cassidy, Robert H. Powrie, David G. Priest, Mark A. Zorbas, Timothy W. Synold, Stephen Shibata, Darcy Spicer, Donald Bissett, Yazdi K. Pithavala, Mary A. Collier, Linda J. Paradiso, John D. Roberts (Jul-2000). "Pharmacokinetic and Pharmacodynamic Evaluation of the Glycinamide Ribonucleotide Formyltransferase Inhibitor AG2034". Clinical Cancer Research (American Association for Cancer Research) 6 (7): 2677–2684. PMID 10914709. http://clincancerres.aacrjournals.org/cgi/content/abstract/6/7/2677. Retrieved 2-Dec-2008. 
  2. ^ Avendano, Carmen; Menendez, J. Carlos (16-Apr-2008). Medicinal Chemistry of Anticancer Drugs. Amsterdam: Elsevier. p. 37. ISBN 0-4445-2824-5. http://books.google.com/books?id=GjhXyqB5iLcC. 
  3. ^ "Healthcare Professional Website". ALIMTA.com. Eli Lilly and Company. http://www.alimta.com/hcp/index.jsp. Retrieved 1-Dec-2008. 
  4. ^ "Maintenance pemetrexed (Pem) plus best supportive care (BSC) versus placebo (Plac) plus BSC: A randomized phase III study in advanced non-small cell lung cancer (NSCLC).". American Society of Clinical Oncology. http://www.asco.org/ASCOv2/Meetings/Abstracts?&vmview=abst_detail_view&confID=65&abstractID=33019. Retrieved 22-Jul-2009. 
  5. ^ Ettinger DS et al. NCCN Clinical Practice Guidelines in Oncology: Non-small Cell Lung Cancer V.2.2009 available from www.nccn.org
  6. ^ Azzoli CG, Kris MG, Pfister DG. (2007) Cisplatin versus carboplatin for patients with metastatic non-small-cell lung cancer- An old rivalry renewed. JNCI v99(11) pg. 828-829
  7. ^ "Alimta Patient Packet Insert" (PDF). ALIMTA.com. Eli Lilly and Company. 26-Sep-2008. http://pi.lilly.com/us/alimta-ppi.pdf. Retrieved 1-Dec-2008. 
  8. ^ "Alimta Prescribing Information" (PDF). ALIMTA.com. Eli Lilly and Company. 26-Sep-2008. http://pi.lilly.com/us/alimta-pi.pdf. Retrieved 1-Dec-2008. 
  9. ^ "Important Safety Information". ALIMTA.com. Eli Lilly and Company. 26-Sep-2008. http://www.alimta.com/pat/safetyInformationPAT.jsp. Retrieved 1-Dec-2008. 
  10. ^ James P. Wilmot Cancer Center. "Scientists Help Breast Cancer Survivor Lift the Fog of “Chemo Brain”". Dialogue (University of Rochester Medical Center) Fall 2007: 2–3. http://www.urmc.rochester.edu/cancer-center/documents/fall07.pdf. Retrieved 1-Dec-2008. 
  11. ^ "Oral Complications of Chemotherapy and Head/Neck Radiation". Cancer Topics - Coping with Cancer. National Cancer Institute. http://www.cancer.gov/cancertopics/pdq/supportivecare/oralcomplications/Patient/page5. Retrieved 1-Dec-2008. 


v • d • e
Eli Lilly and Company
Corporate Directors:
Products:
Annual Revenue: $20.4 billion USD (?-10.17% FY 2008) · Employees: 40,250 · Stock Symbol: NYSE: LLY · Website: www.lilly.com
Retrieved from "http://en.wikipedia.org/wiki/Pemetrexed"

This article is licensed under the GNU Free Documentation License. It uses material from the Wikipedia article "Pemetrexed".

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