Clinical Medicine Reviews in Oncology

Pemetrexed is a third generation multi-target agent able to inhibit at least three crucial enzymes involved in the folate pathway. Pemetrexed is indicated in combination with cisplatin as first line treatment of malignant pleural mesothelioma (MPM) and in mono-chemotherapy as second line treatment of advanced non-small-cell lung cancer (NSCLC). In 2008, the combination of pemetrexed plus cisplatin has gained approval in Europe and in USA for first line therapy limited to non squamous NSCLC patients. More recently, the outcome of a large phase III trial, aimed at evaluating pemetrexed as maintenance therapy, confirmed the efficacy of the drug in non squamous NSCLC patients. Recent data suggest tumour histotype and TS expression levels as the most promising predictors of pemetrexed sensitivity in NSCLC.

The aim of this paper is to review literature data about platinum and pemetrexed combination in advanced solid tumors, especially NSCLC and MPM.