The Pharmaceutical Journal
Vol 268 No 7200 p751-757
1 June 2002

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Antifolate increases length of survival

Pemetrexed (Alimta), a novel antifolate that targets specific enzymes involved in purine and pyrimidine synthesis, given in combination with cisplatin has a three-month survival benefit over cisplatin alone in patients with malignant pleural mesothelioma, phase III trial data show. Patients treated with the combination lived for about a year after diagnosis, nearly three months longer than patients who received cisplatin alone.

Dr Nicholas Vogelzang, University of Chicago, and colleagues randomly assigned 456 patients to receive either pemetrexed plus cisplatin or cisplatin alone. They say that tumour shrinkage was seen in 41 per cent of patients treated with pemetrexed plus cisplatin compared with 17 per cent of patients treated with cisplatin alone. Combination treatment was also more effective at reducing pain and shortness of breath, both of which are symptoms of pleural mesothelioma. Patients who were deficient in folic acid and vitamin B12 and who received pemetrexed were more likely to experience severe toxicity, severe diarrhoea and severe mouth ulcers, than those being treated with cisplatin alone. Data were presented at the 2002 meeting of the American Society of Clinical Oncology held in Orlando, Florida, last month.