Pemetrexed (Alimta, Eli Lilly and Company) is an antifolate agent that works by disrupting folate-dependent metabolic processes essential for cancer cell replication and survival. It is licensed as a monotherapy for the treatment of locally advanced or metastatic non-small-cell lung cancer (NSCLC) after prior chemotherapy. For further information see the summary of product characteristics (SPC).
Pemetrexed is associated with suppression of bone marrow function, nausea and vomiting, fatigue and a range of other side effects. For full details of side effects and contraindications, see the SPC.
The recommended dose of pemetrexed is 500mg/m2 body surface area (BSA). It is administered by intravenous infusion over 10 minutes on the first day of each 21-day cycle.
The acquisition cost of pemetrexed is £800 for a 500-mg vial (excluding VAT; BNF, edition 52). Costs may vary in different settings because of negotiated procurement discounts.