Introduction

Pemetor 500 mg (Pemetrexed) Injection represents the highest available concentration of this critical chemotherapeutic agent, providing oncologists with a powerful treatment option for non-small cell lung cancer (NSCLC) and malignant pleural mesothelioma. Manufactured by the renowned Eskayef Pharmaceuticals Ltd. and supplied globally by Orio Pharma, this premium-quality injection contains Pemetrexed, a multi-targeted folate antimetabolite that has revolutionized treatment approaches for these challenging malignancies.

This high-potency formulation contains 500 mg of Pemetrexed in each vial, precisely manufactured under stringent quality control protocols to ensure maximum efficacy, stability, and safety for cancer patients. The sterile lyophilized powder is designed for reconstitution and intravenous administration by qualified healthcare professionals in hospital and clinical settings.

Therapeutic Indications

Pemetor 500 mg is clinically indicated for multiple treatment scenarios in non-squamous non-small cell lung cancer:

• First-Line Therapy: For patients with locally advanced or metastatic, non-squamous NSCLC in combination with cisplatin as initial treatment, establishing a powerful first-line therapeutic approach that targets rapidly dividing cancer cells.
• Maintenance Treatment: 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 extend progression-free survival.
• Second-Line Treatment: For patients with recurrent, metastatic non-squamous NSCLC after prior chemotherapy, providing a valuable therapeutic option when initial treatment regimens have failed.

Additionally, Pemetor is indicated for malignant pleural mesothelioma in combination with cisplatin for patients who are not candidates for surgical resection. This application provides critical therapeutic options for patients with this rare and aggressive cancer type associated with asbestos exposure.

Mechanism of Action

Pemetor works through a sophisticated multi-targeted inhibition of folate-dependent metabolic processes essential for cellular replication. As an antifolate agent, Pemetrexed disrupts DNA synthesis and cellular division by simultaneously inhibiting four key enzymes involved in pyrimidine and purine synthesis:

1. Thymidylate synthase (TS): Blocks conversion of deoxyuridine monophosphate (dUMP) to deoxythymidine monophosphate (dTMP), disrupting DNA synthesis
2. Dihydrofolate reductase (DHFR): Prevents regeneration of tetrahydrofolate, a critical cofactor in nucleotide synthesis
3. Glycinamide ribonucleotide formyltransferase (GARFT): Inhibits purine synthesis
4. Aminoimidazole carboxamide ribonucleotide formyltransferase (AICARFT): Further blocks purine synthesis pathways

This comprehensive inhibition of multiple folate-dependent enzymes blocks the formation of thymidine and purine nucleotides, effectively halting 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 500 mg 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). The high-concentration 500 mg formulation of Pemetor provides flexibility in dosing for various patient body surface areas, potentially reducing the number of vials needed per treatment cycle.

Essential Supportive Care Protocol

To optimize treatment outcomes and minimize adverse effects, a comprehensive premedication protocol should be implemented:

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

This supportive care regimen significantly reduces the incidence and severity of treatment-related toxicities, particularly hematological, gastrointestinal, and dermatological adverse events, enabling patients to maintain treatment schedules and achieve better outcomes.

Clinical Efficacy and Outcomes

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

• In combination with cisplatin for first-line treatment of advanced non-squamous NSCLC, Pemetrexed has shown improved overall 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, particularly for patients who cannot undergo surgical intervention.

Safety Considerations and Monitoring

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

• Myelosuppression: Regular complete blood count monitoring is essential to detect neutropenia, thrombocytopenia, or anemia
• Renal Function: Creatinine clearance should be evaluated before each administration as renal impairment can increase toxicity
• Dermatological Reactions: Ranging from mild rash to severe bullous or exfoliative conditions
• Pulmonary Effects: Monitor for interstitial pneumonitis, presenting as dyspnea, cough, or fever
• Radiation Recall: Inflammatory reactions in previously irradiated areas

Drug interactions should be carefully managed, particularly with NSAIDs, nephrotoxic agents, and medications cleared by tubular secretion. Pemetor carries a Pregnancy Category D classification and is not recommended during pregnancy or breastfeeding.

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

Premium Manufacturing Quality

As a product of Eskayef Pharmaceuticals Ltd., Pemetor 500 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 of Pemetor 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 during preparation and administration. Healthcare professionals should follow established institutional guidelines for the safe handling, preparation, administration, and disposal of chemotherapeutic agents.

Global Availability Through Orio Pharma

Orio Pharma proudly serves as a global distributor of Pemetor 500 mg, making this essential cancer treatment accessible to patients worldwide. Recognizing the time-sensitive nature of cancer treatment, Orio Pharma offers expedited worldwide delivery, ensuring that healthcare providers and patients receive this crucial medication within 3 to 7 working days, regardless of location.

Commitment to Cancer Care Excellence

The availability of Pemetor 500 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 500 mg or to place an order, please visit www.oriopharma.com or contact our dedicated oncology specialists who can provide detailed information about product availability, pricing, and delivery options for your specific location.Retry