Alimta (premetrexed) for ovarian cancer – pro

Pemetrexed (Alimta) is an antifolate agent that possesses antitumor activity in a variety of solid tumors, including mesothelioma and non-small-cell lung, gastrointestinal, head and neck, breast, and gynecologic cancers.
The observation of responses in patients with ovarian cancer in phase I studies of the combination of pemetrexed and gemcitabine prompted the development of a phase II trial of the combination as secondline chemotherapy in patients with recurrent platinum-sensitive or -resistant ovarian primary cancers. This study was terminated after a randomized study showed that Alimta was not of benefit. Lily recently released toxicity results of its study of Alimta for ovarian cancer, 9710, A Randomized, Double-Blind, Phase 2 Study of Two Doses of Pemetrexed in the Treatment of Platinum-Resistant, Epithelial Ovarian or Primary Peritoneal Cancer.

NCCN on p.OVD, 1 of its ovarian cancer guideline does separately list premeterexed as appropriate for recurrent ovarian cancer and it also lsits Avastin for recurrence.

Miller RE1, Banerjee S.The current state of pemetrexed in ovarian cancer.Expert Opin Investig Drugs. 2013 Sep;22(9):1201-10.

Campbell IG, Jones TA, Foulkes WD, et al: Folate-binding protein is a marker for ovarian cancer. Cancer Res 51:5329-5338, 1991.

Toffoli G, Russo A, Gallo A, et al: Expression of folate binding protein as a prognostic factor for response to platinum-containing chemotherapy and survival in human ovarian cancer. Int J Cancer 79:121-126, 1998.

Siegel BA, Dehdashti F, Mutch DG, et al: Evaluation of 111In-DTPA-folate as a receptor- targeted diagnostic agent for ovarian cancer: Initial clinical results. J Nucl Med 44:700-707, 2003.

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