Pemetrexed

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Pemetrexed
Clinical data
Trade namesAlimta, Pemfexy, Ciambra, others
AHFS/Drugs.comMonograph
License data
Pregnancy
category
  • AU: D
Routes of
administration		Intravenous
ATC code
Legal status
Legal status
Pharmacokinetic data
BioavailabilityNA
Protein binding81%
MetabolismNegligible
Elimination half-life3.5 hours
ExcretionKidney
Identifiers
  • (2S)-2-{[4-[2-(2-amino-4-oxo-1,7-dihydropyrrolo[2,3-d]pyrimidin-5-yl)ethyl]benzoyl]amino}pentanedioic acid
JSmol)
  • Nc3nc2[nH]cc(CCc1ccc(C(=O)N[C@@H](CCC(=O)O)C(=O)O)cc1)c2c(=O)[nH]3
  • InChI=1S/C20H21N5O6/c21-20-24-16-15(18(29)25-20)12(9-22-16)6-3-10-1-4-11(5-2-10)17(28)23-13(19(30)31)7-8-14(26)27/h1-2,4-5,9,13H,3,6-8H2,(H,23,28)(H,26,27)(H,30,31)(H4,21,22,24,25,29)/t13-/m0/s1 checkY
  • Key:WBXPDJSOTKVWSJ-ZDUSSCGKSA-N checkY
 ☒NcheckY (what is this?)  (verify)

Pemetrexed, sold under the brand name Alimta among others, is a

non-small cell lung cancer (NSCLC).[2]
.

It is available as a

generic medication.[6][7]

Medical use

In February 2004, the U.S.

non-small cell lung cancer (NSCLC) in patients with non-squamous histology.[10][11][2]

Carboplatin

Pemetrexed is also recommended in combination with carboplatin and pembrolizumab for the first-line treatment of advanced non-small cell lung cancer.[12][13] 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.[14]

Supplementation

Patients are recommended to take

folic acid and vitamin B12 supplement even if levels are normal when they are on pemetrexed therapy.[15][2] (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 glucocorticoid (e.g. dexamethasone) on the day prior, day of, and day after pemetrexed infusion to avoid skin rashes.[2]

Side effects

Pemetrexed, whether used alone or in combination with cisplatin, has these side effects:[2]

Mechanism of action

Pathway of tetrahydrofolate and antimetabolites

Pemetrexed is chemically similar to

glycinamide ribonucleotide formyltransferase[18][19] (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.

Society and culture

Economics

In the United States, as of 2015[update], each vial of the medication costs between US$2,623 and US$3,100.[20]

Brand names

In February 2020, Pemfexy was approved for use in the United States.[21]

Research

A Phase III study showed benefits of maintenance use of pemetrexed for non-squamous NSCLC.[22] Activity has been shown in malignant peritoneal mesothelioma.[23]

References

  1. ^ "Prescription medicines: registration of new generic medicines and biosimilar medicines, 2017". Therapeutic Goods Administration (TGA). 21 June 2022. Retrieved 30 March 2024.
  2. ^ a b c d e f "Alimta- pemetrexed disodium injection, powder, lyophilized, for solution". DailyMed. 25 March 2020. Archived from the original on 20 October 2020. Retrieved 20 October 2020.
  3. ^ "Pemfexy- pemetrexed injection". DailyMed. 20 January 2022. Archived from the original on 21 May 2022. Retrieved 20 May 2022.
  4. ^ "Alimta EPAR". European Medicines Agency. 17 September 2018. Archived from the original on 18 January 2021. Retrieved 14 October 2022.
  5. ^ "Pemetrexed Baxter: Pending EC decision". European Medicines Agency. 14 October 2022. Archived from the original on 14 October 2022. Retrieved 14 October 2022.
  6. ^ "2022 First Generic Drug Approvals". U.S. Food and Drug Administration (FDA). 3 March 2023. Archived from the original on 30 June 2023. Retrieved 30 June 2023.
  7. ^ "Competitive Generic Therapy Approvals". U.S. Food and Drug Administration (FDA). 29 June 2023. Archived from the original on 29 June 2023. Retrieved 29 June 2023.
  8. PMID 12917819
    .
  9. ^ National Cancer Institute: FDA Approval for Pemetrexed Disodium Archived 6 April 2015 at the Wayback Machine
  10. S2CID 28209589
    .
  11. PMID 19577816
    .
  12. ^ Ettinger DS, et al. "Non-small Cell Lung Cancer V.1.2007" (PDF). NCCN Clinical Practice Guidelines in Oncology. National Comprehensive Cancer Network (NCCN). Archived from the original (PDF) on 23 March 2007.
  13. PMID 29658856
    .
  14. PMID 17551137
    .
  15. S2CID 11444611
    .
  16. ^ "Scientists Help Breast Cancer Survivor Lift the Fog of "Chemo Brain"" (PDF). Dialogue. James P Wilmot Cancer Center, University of Rochester Medical Center: 2–3. Fall 2007. Retrieved 1 December 2008.[permanent dead link]
  17. ^ "Oral Complications of Chemotherapy and Head/Neck Radiation". Cancer Topics – Coping with Cancer. National Cancer Institute. Archived from the original on 6 December 2008. Retrieved 1 December 2008.
  18. PMID 10914709. Archived
    from the original on 28 July 2009. Retrieved 2 December 2008.
  19. ISBN 978-0-444-52824-7
    .
  20. ^ Langreth R (29 June 2016). "Decoding Big Pharma's Secret Drug Pricing Practices". Bloomberg. Archived from the original on 13 July 2016. Retrieved 15 July 2016.
  21. ^ "Pemfexy: FDA-Approved Drugs". U.S. Food and Drug Administration (FDA). Archived from the original on 19 October 2020. Retrieved 13 February 2020.
  22. doi:10.1200/jco.2009.27.18_suppl.cra8000. Archived from the original
    on 16 June 2009. Retrieved 22 July 2009.
  23. PMID 19042053
    .

External links
Retrieved from "https://en.wikipedia.org/w/index.php?title=Pemetrexed&oldid=1216434034"