Pemetrex 100 mg is a formulation containing pemetrexed disodium, a multi-targeted antifolate chemotherapeutic agent. It is available as a lyophilized powder for intravenous infusion, reconstituted and diluted prior to administration by trained oncology professionals.

Pemetrexed represents a significant advance in the management of non-small cell lung cancer (NSCLC) and malignant pleural mesothelioma, offering a targeted approach to disrupting folate-dependent processes essential for cancer cell replication.

Mechanism of Action

Pemetrexed is structurally similar to folic acid and acts by inhibiting several folate-dependent enzymes that are crucial for the synthesis of nucleotides needed for DNA replication and cell division. These include:

• Thymidylate synthase (TS)

• Dihydrofolate reductase (DHFR)

• Glycinamide ribonucleotide formyltransferase (GARFT)

By blocking these enzymes, pemetrexed disrupts the synthesis of thymidine and purine nucleotides, leading to interference with DNA and RNA synthesis. This results in the inhibition of cancer cell proliferation and induction of apoptosis, particularly in rapidly dividing tumor cells.

Uses

Pemetrex (Pemetrexed) 100 mg is indicated for:

Malignant Pleural Mesothelioma (MPM):

• In combination with cisplatin, for the treatment of patients who are not candidates for curative surgery.

Non-Small Cell Lung Cancer (NSCLC):

• First-line therapy: In combination with cisplatin for locally advanced or metastatic non-squamous NSCLC.

• Maintenance therapy: As a single agent in patients whose disease has not progressed after four cycles of platinum-based first-line chemotherapy.

• Second-line therapy: As monotherapy for locally advanced or metastatic non-squamous NSCLC after prior chemotherapy.

  Adverse Effects

  Pemetrexed, like other cytotoxic agents, is associated with a range of adverse effects. Many can be mitigated with premedication and supportive care.

  Common adverse effects

  • Hematologic toxicity: Neutropenia, anemia, thrombocytopenia; necessitating routine blood counts.

  • Gastrointestinal symptoms: Nausea, vomiting, diarrhea, mucositis, stomatitis.

  • Fatigue and asthenia