Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Currently, the four-drug combination of methotrexate, vinblastine, doxorubicin (Adriamycin), and cisplatin (MVAC) or the two-drug combination of gemcitabine and cisplatin (GC) represents the standard of care for patients with locally advanced and metastatic transitional cell carcinoma of the urothelium. Recently, there has been a plethora of data from other chemotherapeutic regimens. Promising new agents, such as the multitargeted antifolate pemetrexed (Alimta), and new drug combinations have demonstrated increased efficacy and/or decreased toxicity compared with current regimens. Currently, data are available from three phase II studies utilizing pemetrexed or the combination of pemetrexed/gemcitabine (Gemzar) in patients with locally advanced and metastatic transitional cell carcinoma of the urothelium. Further investigation of combinations of pemetrexed and other active drugs in the treatment of patients with locally advanced and metastatic disease is warranted.
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PMID:Pemetrexed in transitional cell carcinoma of the urothelium. 1565 37

Pemetrexed (Alimta) shows single-agent activity in advanced colorectal cancer. In two phase II studies in which patients received pemetrexed at 600 mg/m2 or 500 mg/m2 as first-line treatment for metastatic disease, objective response rates were 15.4% and 17.2%. These trials were conducted prior to supplementation with folic acid and vitamin B12, which markedly decreased the frequency of hematologic toxicities of pemetrexed; routine supplementation is now included in all clinical trials of the agent. The marked improvement in toxicity and tolerance with vitamin supplementation suggests the need to reexamine optimal dosing in pemetrexed combination schedules. In a National Surgical Adjuvant Breast and Bowel Project phase II trial in 54 patients with previously untreated advanced colorectal cancer, pemetrexed at 500 mg/m2 plus oxaliplatin (Eloxatin) at 120 mg/m2 every 21 days with folic acid/vitamin B12 supplementation resulted in an objective response of 23%. Three additionalpatients (5.6%) had unconfirmed partial response (partial response at one visit), and 27 patients (50%) had stable disease. Median progression-free survival was 5.3 months and median duration of response was 5.7 months; median overall survival was approximately 11.05 months. Grade 3/4 neutropenia was observed in only 17% of patients and treatment was well tolerated. A phase I/II study is under way to identify and assess the optimal combination of pemetrexed/irinotecan in second-line treatment of advanced colorectal cancer. Planned studies include a phase I study examining the combination of pemetrexed and oxaliplatin given every 2 weeks as first-line treatment, and a phase I/II trial to identify the optimal pemetrexed/ oxaliplatin dose in a 21-day schedule and to compare pemetrexed/ oxaliplatin with FOLFOX4 in first-line treatment of metastatic disease. All of these trials include vitamin supplementation. A phase III trial comparing the every-3-week pemetrexed/oxaliplatin regimen with FOLFOX4 as first-line treatment will be initiated if the outcome of the phase II trial is encouraging.
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PMID:Pemetrexed in advanced colorectal cancer. 1565 39