Pemetrexed chemical structure
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Alimta

Pemetrexed (brand name Alimta) is a chemotherapy drug. Its indications are the treatment of pleural mesothelioma as well as non-small cell lung cancer. more...

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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 formyl transferase (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.

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.

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 July 2004, the FDA granted approval as a second-line agent for the treatment of non-small cell lung cancer.

Patients are required to be on folic acid and vitamin B12 supplementation when they are on pemetrexed therapy. (In clinical trials for mesothelioma, folic acid and B12 supplementation reduced the frequency of adverse events.)

Read more at Wikipedia.org


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FDA approves cancer drug Alimta
From Deseret News (Salt Lake City), 8/20/04

WASHINGTON (AP) -- The Food and Drug Administration on Thursday approved a cancer drug made by pharmaceutical giant Eli Lilly and Co. to treat advanced non-small cell lung cancer in patients who have undergone chemotherapy.

According to the American Cancer Society, non-small cell lung cancer is the leading cause of cancer-related deaths in the nation. Eighty percent of 174,000 new lung cancer cases diagnosed each year are non-small cell lung cancer. By the time most patients arrive for treatment, the cancer is widespread.

The drug, Alimta, in clinical trials was found to shrink tumors as effectively as another cancer-fighting drug, Taxotere. But Alimta did so with fewer troubling side effects, which include hair loss, tingling fingers and toes, depressed blood count, and hospitalizations for subsequent infection.

"Lung cancer is a very devastating disease and the therapies can be hard on patients," said Roy Herbst, chief of thoracic oncology at MD Anderson Cancer Center. The Houston, Texas, facility sees nearly 1,500 new lung cancer patients per year and treated at least 20 in the Alimta vs. Taxotere study.

One in 50 patients taking Alimta had side effects. That benefit came without any lessening of the drug's effectiveness. That's significant as cancer care moves toward more combination drug or sequential therapies, Herbst said.

"We can only do that if the drugs we give (patients) leave them in a state ... where they're still strong. You can kill the cancer, but leave the patient feeling well," he said.

The Alimta treatment, 500 mg every 21 days, costs patients $3,900 per month, according to the company. The anti-cancer drug works by interfering with three enzymes on which tumors depend.

"There's no question, the survival was comparable to the survival with the best drugs we have," said Dr. Paul Bunn, director of the University of Colorado Cancer Center and principal investigator for the clinical trial. "This drug is as good as anything else we have. It does benefit patients."

Dr. Richard Gralla, president of the New York Lung Cancer Alliance, estimated tens of thousands of lung-cancer patients per year would be eligible to take Alimta.

The trial tested a simple way to reduce side effects: Taking Alimta in concert with folate pills and B-12 injections.

"When you take those special B vitamins, it further reduces the side effects of the chemotherapy," Gralla said.

On the Net: Eli Lilly and Company: www.lilly.com

Copyright C 2004 Deseret News Publishing Co.
Provided by ProQuest Information and Learning Company. All rights Reserved.

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