Alimta (Pemetrexed) for Lung Cancer

Overview
Alimta is approved by the U.S. Food and Drug Administration (FDA) to treat certain types of non-squamous non-small cell lung cancer (NSCLC). Alimta can be used in different ways depending on the stage and type of lung cancer It may be combined with other cancer drugs like pembrolizumab and platinum-based chemotherapy for first-time treatment of advanced NSCLC, but only if the cancer doesn’t have specific gene changes (EGFR or ALK abnormalities). It also may be combined with a drug called cisplatin to treat advanced cases of NSCLC. Additionally, it may be used alone to help keep the cancer from coming back after chemotherapy or to treat recurring lung cancer (cancer that has come back) when other treatments have been tried. Alimta is also known by its drug name, pemetrexed.

Alimta is part of a drug group called folate analog metabolic inhibitors (or antimetabolites). These drugs work by blocking certain cell functions that cancer cells need to grow and divide. By interrupting these functions, Alimta can help slow or stop the growth of cancer cells.

How do I take it?
Prescribing information states that Alimta is administered as an intravenous (IV) infusion. When used in combination with pembrolizumab and platinum chemotherapy, Alimta is generally given over 10 minutes on the first day of a 21-day cycle, following pembrolizumab and prior to platinum chemotherapy. When used alone or with cisplatin, Alimta is generally given as a 10-minute intravenous infusion on the first day of each 21-day cycle. A person also may also take folic acid, vitamin B12, and dexamethasone to help reduce treatment side effects. Alimta should be taken exactly as prescribed by a health care provider.

Side effects
Common side effects of Alimta include fatigue, nausea, and loss of appetite when used as a single agent. When administered with cisplatin, common side effects are vomiting, neutropenia (low white blood cell count), anemia (low red blood cell count), inflammation of the mouth or throat, thrombocytopenia (low platelet count), and constipation. When Alimta is used with pembrolizumab and platinum chemotherapy, common side effects include fatigue, nausea, constipation, diarrhea, reduced appetite, skin rash, vomiting, cough, shortness of breath, and fever.

Rare but serious side effects may include severe bone marrow suppression leading to infection risk, kidney failure, severe skin reactions (such as blistering or peeling skin), interstitial pneumonitis (lung inflammation), and radiation recall (inflammation of previously irradiated areas). Alimta also can harm an unborn baby if used by a person who is pregnant.

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Label: Alimta — Pemetrexed Disodium Injection, Powder, Lyophilized, for Solution — DailyMed