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.
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.