Pemetrexed

Author:Prof. Dr. med. Peter Altmeyer

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Last updated on: 27.02.2022

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DefinitionThis section has been translated automatically.

Pemetrexed is a folic acid antagonist with antitumoral, antiproliferative and cytostatic properties. In a narrower sense, folic acid analogues are a small group of (non-selectively acting) cytostatic drugs (so-called antimetabolites) with methotrexate (MTX) as the lead substance. The effects of pemetrexed are based on the inhibition of folate-dependent metabolic processes that are important for cell division. Pemetrexed inhibits the folate-dependent enzymes:

  • Thymidylate synthase
  • dihydrofolate reductase and
  • Glycinamide ribonucleotide formyltransferase.

These enzymes are involved in the biosynthesis of pyrimidine and purine nucleotides. These are components of DNA and RNA that are required for these. The half-life of pemetrexed is about 3.5 hours.

IndicationThis section has been translated automatically.

Malignant pleural mesothelioma (C45.0).

In combination with cisplatin for the treatment of chemonaive patients with unresectable malignant pleural mesothelioma.

Non-small cell lung cancer (NSCLC - C34.9).

Pemetrexed is indicated in combination with cisplatin for the first-line treatment of patients with locally advanced or metastatic non-small cell lung cancer (C34.9)

Dosage and method of useThis section has been translated automatically.

Monotherapy: In patients with non-small cell lung cancer after prior chemotherapy, the recommended dose of pemetrexed is 500 mg/m² KOF administered as an intravenous infusion over a 10-minute period on the first day of each 21-day treatment cycle.

Note: Premedication: To reduce the frequency and severity of skin reactions, a glucocorticoid(e.g., 2x 4 mg dexamethasone p.o.) must be given the day before and the day of pemetrexed administration and the day after treatment.

Undesirable effectsThis section has been translated automatically.

General ADRs:

  • General tendency to infection
  • Fatigue (tiredness)
  • Fever
  • Oedema tendency

UAW of the mucous membranes

  • Pharyngitis
  • Stomatitis
  • ulcers of the mucous membranes

Hematological UAW

  • Neutropenia
  • Thrombocytopenia
  • Anemia

Gastrointestinal UAW

  • Oesophagitis
  • Loss of appetite
  • Vomiting
  • Diarrhoea
  • Nausea
  • Colitis

Dermatological UAW:

  • Erythema
  • Hyperpigmentation of the skin
  • Pruritus
  • Erythema multiforme
  • Urticaria
  • Ophthalmologic ADR
  • Drought,
  • Conjunctivitis

Cardiological UAW

  • Heart Failure
  • Arrhythmias

Hepatological UAW

  • Pathological liver serology

Nephrological UAW

  • Renal insufficiency

PreparationsThis section has been translated automatically.

Raltitrexed®

LiteratureThis section has been translated automatically.

  1. Adjei A.A (2004) Pemetrexed (ALIMTA), a novel multitargeted antineoplastic agent. Clin Cancer Res 10: 4276s-4280s

  2. Curtin NJ et al (2001) Pemetrexed disodium, a novel antifolate with multiple targets. Lancet Oncol 2: 298-306

  3. Ramalingam SS et al (2019) Pemetrexed, Bevacizumab, or the Combination As Maintenance Therapy for Advanced Nonsquamous Non-Small-Cell Lung Cancer: ECOG-ACRIN 5508 J Clin Oncol 37(:2360-2367

Authors

Last updated on: 27.02.2022

Author: Prof. Dr. med. Peter Altmeyer