Introduction

Pemetor 100 mg (Pemetrexed) Injection represents a breakthrough in targeted cancer therapy, providing oncologists with a powerful and specific treatment option for non-small cell lung cancer (NSCLC) and malignant pleural mesothelioma. Manufactured by the renowned Eskayef Pharmaceuticals Ltd. and distributed globally by Orio Pharma, this premium-quality injection contains Pemetrexed, a clinically validated folate antimetabolite that has significantly improved treatment outcomes for patients with these challenging malignancies.

Each vial of Pemetor contains 100 mg of Pemetrexed, precisely formulated under stringent quality control protocols to ensure maximum efficacy, stability, and safety for patients undergoing cancer treatment. The medication is presented as a sterile lyophilized powder for reconstitution, designed for intravenous administration by qualified healthcare professionals.

Therapeutic Applications

Pemetor is clinically indicated for multiple treatment scenarios in non-small cell lung cancer:

• Initial Treatment: For patients with locally advanced or metastatic, non-squamous NSCLC in combination with cisplatin, establishing an effective first-line therapeutic approach.
• Maintenance Therapy: As a single agent for patients with locally advanced or metastatic, non-squamous NSCLC whose disease has not progressed after four cycles of platinum-based first-line chemotherapy, helping to preserve treatment gains and delay disease progression.
• Recurrent Disease: For patients with recurrent, metastatic non-squamous NSCLC after prior chemotherapy, offering a valuable second-line treatment option.

Additionally, Pemetor is indicated for malignant pleural mesothelioma, where it is administered in combination with cisplatin for patients who cannot receive surgical intervention. This application provides critical therapeutic options for patients with this rare and aggressive cancer type.

Mechanism of Action

Pemetor works through a sophisticated multi-targeted inhibition of folate-dependent metabolic processes essential for cell replication. As a thymidylate synthase inhibitor, Pemetrexed disrupts DNA synthesis and cellular division by inhibiting four key enzymes involved in folate metabolism:

1. Thymidylate synthase (TS)
2. Dihydrofolate reductase (DHFR)
3. Glycinamide ribonucleotide formyltransferase (GARFT)
4. Aminoimidazole carboxamide ribonucleotide formyltransferase (AICARFT)

This comprehensive inhibition of folate-dependent enzymes blocks the formation of thymidine and purine nucleotides, disrupting DNA and RNA synthesis particularly in rapidly dividing cells such as cancer cells. By affecting multiple targets simultaneously, Pemetrexed offers enhanced efficacy compared to single-target antimetabolites.

Dosage and Administration Protocol

Pemetor is administered as an intravenous infusion over 10 minutes according to specific treatment protocols based on the indication:

For Non-Squamous NSCLC:

• Initial Treatment: 500 mg/m² administered prior to cisplatin on Day 1 of each 21-day cycle for up to six cycles
• Maintenance Treatment: 500 mg/m² on Day 1 of each 21-day cycle until disease progression or unacceptable toxicity
• Recurrent Disease: 500 mg/m² on Day 1 of each 21-day cycle until disease progression or unacceptable toxicity

For Malignant Pleural Mesothelioma:

• 500 mg/m² in combination with cisplatin on Day 1 of each 21-day cycle until disease progression or unacceptable toxicity

All dosing regimens require patients to have a creatinine clearance of 45 mL/min or greater (calculated by the Cockcroft-Gault equation). Premedication with folate, vitamin B₁₂, and corticosteroids is essential to reduce treatment-related toxicities and enhance tolerability.

Supportive Care Recommendations

To optimize treatment outcomes and minimize adverse effects, the following premedication protocol is recommended:

• Folic Acid: 400-1000 mcg daily, beginning 7 days before the first dose of Pemetor and continuing for 21 days after the last dose
• Vitamin B₁₂: 1000 mcg intramuscularly, administered 7 days before the first dose and repeated every three cycles
• Corticosteroid: Dexamethasone 4 mg orally twice daily for three days, beginning the day before administration of Pemetor

This comprehensive supportive care regimen significantly reduces the incidence and severity of treatment-related toxicities, particularly hematological, gastrointestinal, and dermatological adverse events.

Clinical Efficacy

Pemetrexed has demonstrated significant clinical efficacy in multiple large-scale clinical trials:

• In combination with cisplatin for first-line treatment of advanced non-squamous NSCLC, Pemetrexed has shown improved survival rates and favorable toxicity profiles compared to other combination regimens
• As maintenance therapy, Pemetrexed significantly extends progression-free survival and overall survival in patients with stable disease after initial platinum-based therapy
• For malignant pleural mesothelioma, the combination of Pemetrexed with cisplatin has become a standard of care, offering meaningful survival benefits in this difficult-to-treat malignancy

These clinical outcomes have established Pemetor as an essential component of modern oncological treatment protocols for non-squamous NSCLC and mesothelioma.

Safety Considerations and Adverse Effects

While Pemetor is generally well-tolerated, especially with appropriate premedication, healthcare providers should monitor patients for potential adverse reactions including:

• Myelosuppression: Regular complete blood count monitoring is essential to detect neutropenia, thrombocytopenia, or anemia
• Renal Effects: Creatinine clearance should be evaluated before each administration
• Dermatological Reactions: Ranging from mild rash to severe bullous or exfoliative conditions
• Interstitial Pneumonitis: Presenting as dyspnea, cough, or fever
• Radiation Recall: Inflammatory reactions in previously irradiated areas

Pemetor carries a Pregnancy Category D classification, indicating positive evidence of human fetal risk. Women should be advised not to breastfeed during treatment with Pemetrexed and for one week after the final dose.

Special Population Considerations

Renal Impairment: Pemetor is not recommended for patients with creatinine clearance below 45 mL/min

Geriatric Use: While effective in older populations, patients aged 65 and over may experience higher incidences of Grade 3-4 adverse events including anemia, fatigue, thrombocytopenia, hypertension, and neutropenia

Pediatric Use: Safety and effectiveness have not been established in pediatric patients

Quality Assurance

As a product of Eskayef Pharmaceuticals Ltd., Pemetor 100 mg undergoes rigorous quality control throughout its manufacturing process. Eskayef maintains state-of-the-art production facilities that comply with international Good Manufacturing Practice (GMP) standards, ensuring consistent product quality, potency, and safety.

Each batch undergoes comprehensive analysis for purity, stability, sterility, and endotoxin levels before release, guaranteeing that oncology patients receive only the highest quality medication for their cancer treatment.

Storage and Handling

Pemetor should be stored at 25°C (77°F) with excursions permitted between 15-30°C (59-86°F). As a cytotoxic agent, Pemetor requires special handling procedures. Healthcare professionals should follow established guidelines for the preparation, administration, and disposal of chemotherapeutic agents.

Global Availability Through Orio Pharma

Orio Pharma proudly serves as a global supplier of Pemetor 100 mg, making this essential cancer treatment accessible to patients worldwide. Recognizing the time-sensitive nature of cancer treatment, Orio Pharma offers expedited worldwide delivery of Pemetor, ensuring that healthcare providers and patients receive this crucial medication within 3 to 7 working days, regardless of location.

Conslusion

The availability of Pemetor 100 mg represents the shared commitment of Eskayef Pharmaceuticals and Orio Pharma to advancing cancer care globally. By providing consistent access to high-quality oncology medications, these organizations contribute significantly to improving treatment outcomes and offering hope to patients battling non-small cell lung cancer and mesothelioma.

Healthcare professionals choosing Pemetor for their patients can do so with confidence, knowing they’re prescribing a medication manufactured with precision, distributed with care, and backed by organizations dedicated to fighting cancer through pharmaceutical excellence.

For additional information about Pemetor 100 mg or to place an order, please visit www.oriopharma.com or contact our dedicated oncology product specialists.