Editing Pemetrexed (section)

==Medical use==
In February 2004, the U.S. [[Food and Drug Administration]] (FDA) approved pemetrexed for treatment of malignant pleural mesothelioma, a type of tumor of the [[mesothelium]], the thin layer of tissue that covers many of the internal organs, in combination with [[cisplatin]]<ref>{{cite journal | vauthors = Manegold C | title = Pemetrexed (Alimta, MTA, multitargeted antifolate, LY231514) for malignant pleural mesothelioma | journal = Seminars in Oncology | volume = 30 | issue = 4 Suppl 10 | pages = 32–36 | date = August 2003 | pmid = 12917819 | doi = 10.1016/S0093-7754(03)00283-5 }}</ref> for patients whose disease is either unresectable or who are not otherwise candidates for curative surgery.<ref>National Cancer Institute: [http://www.cancer.gov/cancertopics/druginfo/fda-pemetrexed-disodium#malignant_pleural FDA Approval for Pemetrexed Disodium] {{Webarchive|url=https://web.archive.org/web/20150406010932/http://www.cancer.gov/cancertopics/druginfo/fda-pemetrexed-disodium#malignant_pleural |date=6 April 2015 }}</ref> In September 2008, the FDA granted approval as a first-line treatment, in combination with cisplatin, against locally advanced and metastatic [[non-small cell lung cancer]] (NSCLC) in patients with non-squamous histology.<ref>{{cite journal | vauthors = Cohen MH, Justice R, Pazdur R | title = Approval summary: pemetrexed in the initial treatment of advanced/metastatic non-small cell lung cancer | journal = The Oncologist | volume = 14 | issue = 9 | pages = 930–935 | date = September 2009 | pmid = 19737998 | doi = 10.1634/theoncologist.2009-0092 | s2cid = 28209589 | doi-access = free }}</ref><ref>{{cite journal | vauthors = Rossi A, Ricciardi S, Maione P, de Marinis F, Gridelli C | title = Pemetrexed in the treatment of advanced non-squamous lung cancer | journal = Lung Cancer | volume = 66 | issue = 2 | pages = 141–149 | date = November 2009 | pmid = 19577816 | doi = 10.1016/j.lungcan.2009.06.006 }}</ref><ref name="Alimta FDA label" />

===Carboplatin===
Pemetrexed is also recommended in combination with [[carboplatin]] and [[pembrolizumab]] for the first-line treatment of advanced non-small cell lung cancer.<ref>{{cite web | vauthors = Ettinger DS, etal | work = NCCN Clinical Practice Guidelines in Oncology | title = Non-small Cell Lung Cancer V.1.2007 | publisher =  National Comprehensive Cancer Network (NCCN) | url = https://www.nccn.org/professionals/physician_gls/pdf/nscl.pdf | archive-url = https://web.archive.org/web/20070323012050/https://www.nccn.org/professionals/physician_gls/pdf/nscl.pdf | archive-date = 23 March 2007 }}</ref><ref>{{cite journal | vauthors = Gandhi L, Rodríguez-Abreu D, Gadgeel S, Esteban E, Felip E, De Angelis F, Domine M, Clingan P, Hochmair MJ, Powell SF, Cheng SY, Bischoff HG, Peled N, Grossi F, Jennens RR, Reck M, Hui R, Garon EB, Boyer M, Rubio-Viqueira B, Novello S, Kurata T, Gray JE, Vida J, Wei Z, Yang J, Raftopoulos H, Pietanza MC, Garassino MC | display-authors = 6 | title = Pembrolizumab plus Chemotherapy in Metastatic Non-Small-Cell Lung Cancer | journal = The New England Journal of Medicine | volume = 378 | issue = 22 | pages = 2078–2092 | date = May 2018 | pmid = 29658856 | doi = 10.1056/NEJMoa1801005 | collaboration = KEYNOTE-189 Investigators | doi-access = free | hdl = 10138/298862 | hdl-access = free }}</ref> However, the relative efficacy or toxicity of pemetrexed-cisplatin versus pemetrexed-carboplatin has not been established beyond what is generally thought about cisplatin or carboplatin doublet drug therapy.<ref>{{cite journal | vauthors = Azzoli CG, Kris MG, Pfister DG | title = Cisplatin versus carboplatin for patients with metastatic non-small-cell lung cancer--an old rivalry renewed | journal = Journal of the National Cancer Institute | volume = 99 | issue = 11 | pages = 828–829 | date = June 2007 | pmid = 17551137 | doi = 10.1093/jnci/djk222 | doi-access = free }}</ref>

===Supplementation===
Patients are recommended to take [[folic acid]] and [[vitamin B12|vitamin B<sub>12</sub>]] supplement even if levels are normal when they are on pemetrexed therapy.<ref>{{cite journal | vauthors = Hazarika M, White RM, Johnson JR, Pazdur R | title = FDA drug approval summaries: pemetrexed (Alimta) | journal = The Oncologist | volume = 9 | issue = 5 | pages = 482–488 | year = 2004 | pmid = 15477632 | doi = 10.1634/theoncologist.9-5-482 | s2cid = 11444611 }}</ref><ref name="Alimta FDA label">{{cite web | title=Alimta- pemetrexed disodium injection, powder, lyophilized, for solution | website=DailyMed | date=25 March 2020 | url=https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=f5a860f3-37ec-429c-ae04-9c88d7c55c08 | access-date=20 October 2020 | archive-date=20 October 2020 | archive-url=https://web.archive.org/web/20201020074626/https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=f5a860f3-37ec-429c-ae04-9c88d7c55c08 | url-status=live }}</ref> (In clinical trials for mesothelioma, folic acid and B12 supplementation reduced the frequency of adverse events.)  It is also recommended for patients to be on a [[glucocorticoid]] (e.g. [[dexamethasone]]) on the day prior, day of, and day after pemetrexed infusion to avoid skin rashes.<ref name="Alimta FDA label" />