Manegold Christian
Thoraxklinik-Heidelberg GmbH, Germany.
Semin Oncol. 2003 Aug;30(4 Suppl 10):32-6. doi: 10.1016/s0093-7754(03)00283-5.
Regimens with antimetabolites such as gemcitabine administered alone or in combination with cisplatin have shown promising phase II study data. Accordingly, antifolate agents are of considerable interest. Pemetrexed (Alimta; Eli Lilly and Company, Indianapolis, IN), a folate-based inhibitor of thymidylate synthase., is currently under phase III investigation. The Evaluation of Mesothelioma in a Phase III Trail of Pemetrexed with Cisplatin (EMPHACIS) trial is the first phase III randomized study in mesothelioma with survival as the primary end point; it showed statistically significant superiority of the pemetrexed/cisplatin combination over cisplatin low-dose folic acid and vitamin B12 supplementation significantly reduced the toxicity observed with the use of pemetrexed/cisplatin will soon be recommended for malignant pleural mesothelioma as first-line standard chemotherapy.
使用抗代谢药物（如吉西他滨单独使用或与顺铂联合使用）的治疗方案已显示出有前景的II期研究数据。因此，抗叶酸剂备受关注。培美曲塞（力比泰；礼来公司，印第安纳波利斯，印第安纳州），一种基于叶酸的胸苷酸合成酶抑制剂，目前正处于III期研究阶段。培美曲塞联合顺铂治疗间皮瘤的III期试验（EMPHACIS）是间皮瘤领域首个以生存为主要终点的III期随机研究；该研究显示培美曲塞/顺铂联合方案在统计学上显著优于顺铂，低剂量叶酸和维生素B12补充剂显著降低了使用培美曲塞/顺铂时观察到的毒性，不久将被推荐用于恶性胸膜间皮瘤的一线标准化化疗。
