Clinical Update on Pemetrexed

The articles in this supplement to ONCOLOGY, "Clinical Update onPemetrexed," are presented by leading international clinical andpreclinical investigators in the arenas of thoracic, gastrointestinal, breast, andgynecologic cancers. They cover a wide range of topics that focus on the promisingagent pemetrexed (Alimta).Pemetrexed is a novel folate antimetabolite that inhibits thymidylate synthase,dihydrofolate reductase, and glycinamide ribonucleotide formyl transferase, all ofwhich are involved in pyrimidine and purine synthesis, resulting in impeded synthesisof the nucleotide precursors of DNA and RNA. This agent has demonstrated activity inclinical trials in a variety of tumor types, such as those presented herein.In February 2004, the US Food and Drug Administration (FDA) approvedpemetrexed-in combination with cisplatin, a commonly used chemotherapy agent-for use in the treatment of malignant pleural mesothelioma, a devastating cancer oftenassociated with asbestos exposure. In July 2004, The Oncologic Drugs AdvisoryCommittee (ODAC) of the FDA positively endorsed pemetrexed for acceleratedapproval as monotherapy in the second-line treatment of non-small-cell lung cancer.The topics in this volume include the biochemical pharmacology of pemetrexed,preclinical/phase I studies, and phase II and III studies in thoracic (non-small-cell lung cancer and mesothelioma), gastrointestinal (pancreas, bladder,colorectal, and gastric), breast, and gynecologic cancers. Moreover, data fromcurrent and future pharmacogenomics and translational research with pemetrexedand gemcitabine (Gemzar) are presented. In addition to presenting current trial datain this volume, the authors present information on clinical trends and the design offuture trials focusing on pemetrexed, either as a single agent or in combination.Finally, an additional goal was to produce enduring material for investigatorsto aid them in current and future study. Therefore, the material contained in thisvolume is intended to be a thorough, objective, balanced presentation of clinical andpreclinical research with pemetrexed in multiple tumor types. I hope that you, thereader, find the data and information to be stimulating, timely, and useful in patientmanagement and/or the design of clinical trials.

Disclosures:

The author(s) have no significant financial interest or other relationship with the manufacturers of any products or providers of any service mentioned in this article.