Pemetrexed Alimta

Used in colorectal cancer outside its approved indication. It appears in 37 clinical trials.

Intravenous Thymidylate synthase dihydrofolate reductase glycinamide ribonucleotide formyltransferase

United States Off-label

European Union EMA approved Since 2005

Spain Hospital use Used off-label in colorectal cancer

What it is

Pemetrexed is a multi-targeted antifolate chemotherapy agent that belongs to the antimetabolite class of cytotoxic drugs. While primarily approved for mesothelioma and non-small cell lung cancer, pemetrexed has limited activity in colorectal cancer and is not part of standard CRC treatment protocols. Its use in CRC is primarily restricted to early-phase clinical trials exploring novel combination therapies, particularly in patients with KRAS-mutated tumors.

How it works

Pemetrexed inhibits multiple folate-dependent enzymes essential for DNA synthesis and cell division, including thymidylate synthase, dihydrofolate reductase, and glycinamide ribonucleotide formyltransferase. By disrupting folate metabolism, the drug prevents cancer cells from producing the nucleotides required for DNA replication and repair, leading to cell cycle arrest and apoptosis.

Molecular targets

Common side effects

FatigueNauseaDecreased appetiteMucositisDiarrheaSkin rashNeutropeniaAnemia

Not all are listed, and everyone experiences them differently. If you notice any, tell your care team.

Trials with this drug

17 recruiting

BMS-986504 in Combination With Pemetrexed for the Treatment of Metastatic Solid Tumors With MTAP Deletion NCT07594626 Recruiting Phase 1 United States A Study of BMS-986504 Monotherapy and in Combination With Other Agents in Participants With Advanced and/or Metastatic Solid Tumors With Homozygous MTAP Deletion (Mounta… NCT07492680 Recruiting Phase 2 United States, Belgium, Canada and 9 more A Solid Tumor Study for Long Term Treatment of Cancer Patients Who Participated in Adagrasib Studies NCT07415031 Recruiting Phase 2 United States, Australia, Belgium and 9 more Study of RAS(ON) Inhibitors in Combination With Ivonescimab in Patients With Solid Tumors NCT07397338 Recruiting Phase 1 United States A Phase 1/2 Study of VS-7375 in Patients With KRAS G12D-Mutated Solid Tumors NCT07020221 Recruiting Phase 1 United States, Australia AK129 Combination Therapy for Advanced Solid Tumors NCT06943820 Recruiting Phase 1 China

See all 37 trials

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