Pemetrexed is an “old” chemotherapy drug that was approved by the FDA in 2004 and has been used in China for many years to treat non-small cell lung cancer and malignant pleural mesothelioma.
Although pemetrexed has not been given an indication for breast cancer, studies have been tried and explored, and this article introduces you to the role of pemetrexed in triple-negative breast cancer.
How pemetrexed kills cancer cells
Folic acid is essential for human metabolism, and some important aspects of cell replication depend on the action of folic acid. Pemetrexed acts as a multi-targeted anti-folate agent. It can disrupt these folate-dependent metabolic processes and achieve the goal of inhibiting tumor cell proliferation. Ultimately, pemetrexed is still a cytotoxic drug that cannot kill tumors with precision.
However, pemetrexed needs to be converted to an active form in the body to be therapeutic, and cancer cells are more likely to undergo conversion than normal cells. Therefore, pemetrexed is more active in cancer cells and has a longer duration of action.
The characteristics of pemetrexed make it less likely to kill cancer cells while affecting normal cells. Also, pemetrexed is multi-targeted to work, has stronger anti-tumor activity, and is less prone to drug resistance.
How does pemetrexed work in triple-negative breast cancer?
There have been several studies of pemetrexed for breast cancer in China. In advanced triple-negative breast cancer that has failed chemotherapy with anthracyclines or paclitaxel, pemetrexed combined with cisplatin regimens are about 30% to 40% effective, delaying disease progression backward by about 5.9 to 6.5 months, with the main adverse effects being bone marrow suppression, rash, and gastrointestinal reactions that resolve with symptomatic treatment.
Summary
The above studies suggest that pemetrexed has some efficacy in advanced triple-negative breast cancer, with remission rates of about 30% to 40% with second-line therapy.
Can I use pemetrexed for advanced triple-negative breast cancer? In addition to considering your own health and disease progression, it is important to fully communicate with your doctor and weigh the pros and cons. It is important to note that pemetrexed treatment may have adverse effects such as allergy, renal insufficiency, gastrointestinal bleeding, and skin rash, which should not be overlooked when choosing a drug to use.