Pemetrexed disodium

• CAS: 150399-23-8
• Catalog Number: ACM150399238
• Category: Main Products
• Molecular Weight: 471.37
• Molecular Formula: C₂₀H₁₉N₅Na₂O₆
• Synonyms: PEMETREXED DISODIUM; PEMETREXED; Pemwtrexed Disodium; PeMetexed DisodiuM; Alimt; PEMETREXED SODIUM; Pemetrexed Dinatrium; Pemetrexed (disodium); ALIMTA
• IUPAC Name: disodium;(2S)-2-[[4-[2-(2-amino-4-oxo-1,7-dihydropyrrolo[2,3-d]pyrimidin-5-yl)ethyl]benzoyl]amino]pentanedioate
• Canonical SMILES: C1=CC(=CC=C1CCC2=CNC3=C2C(=O)N=C(N3)N)C(=O)NC(CCC(=O)[O-])C(=O)[O-].[Na+].[Na+]
• InChI Key: NYDXNILOWQXUOF-GXKRWWSZSA-L
• Appearance: Crystalline Solid
• EC Number: 604-733-2
• Exact Mass: 471.11300
• Hazard Statements: T:Toxic
• Safety Description: S36/37/39-S53

Case Study

The Role of Pemetrexed Disodium in the Treatment of Non-Small Cell Lung Cancer

Rossi, Giovanni, et al. Expert opinion on pharmacotherapy, 2018, 19(17), 1969-1976.

Pemetrexed is a multiple-target folate inhibitor now prescribed for the treatment of advanced non-squamous non-small cell lung cancer (NSCLC) in patients receiving platinum derivatives as first-line therapy or as a single-therapy for second-line treatment. Several related research cases are introduced here.
· First-line
Pemetrexed has been tested before as an independent agent and in combination with cisplatin or carboplatin, and was found to have a low toxicity and effectiveness profile in various non-randomized phase II trials. In particular, the RR was 24% with cisplatin and the median survival was 13.5 months. The primary study, JMDB, was a randomized phase III trial comparing cisplatin-gemcitabine (standard platinum) therapy to cisplatin-pemetrexed. A total of 1,725 eligible patients were randomized to receive cisplatin (75 mg/m²) and pemetrexed (500 mg/m²). The median overall survival was comparable in both groups (10.3 months for pemetrexed). For patients with nonsquamous histology, the median overall survival was 12.6 months in the cisplatin-pemetrexed group compared to 10.9 months for cisplatin-gemcitabine.
· Second line
Moreover, Pemetrexed has undergone numerous evaluations in second-line trials. After positive results from single-arm trials, a phase III randomized trial between pemetrexed and docetaxel was established. The primary endpoint was the non-inferiority of overall survival (OS), which Pemetrexed achieved, with results showing a hazard ratio (HR) of 0.78 (95% CI, 0.61-1.00; p = 0.047) for OS, as well as positive progression-free survival (PFS) outcomes.

Use of Pemetrexed Disodium in Ovarian Cancer

Morotti, M., et al. Expert opinion on investigational drugs, 2012, 21(4), 437-449.

This article gathered the published data regarding pemetrexed (PEM) in the treatment of ovarian cancer (OC), including its mechanism of action, pharmacokinetics, safety and efficacy in recurrent OC. Eight studies compared PEM for OC.
Research with PEM combined with carboplatin in platinum-sensitive OC has resulted in the similar rates of response as other combination therapies. However, the lack of randomized trials comparing this combination with currently used combination therapies makes it difficult to draw conclusions about the efficacy of PEM regimens in these patients.
For platinum-resistant OC, two trials suggest that PEM alone could work as well as other monotherapy agents. The utility of PEM in treating recurrent OC will need to be clarified through more pharmacogenomic and clinical evidence.