Pemetrexed

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Also known as AlimtaLY-231514LY231514NSC-698037PemfexySID124893263SID50112739SID525786[3H]-PemetrexedPemetrexate

Summary

Pemetrexed (CHEMBL225072) is an approved small-molecule antineoplastic agent (ATC L01BA04) targeting DHFR, GART, and TYMS; indicated across 64 conditions including neoplasm and mesothelioma; with CIViC clinical evidence for 13 variant-indication associations (e.g. EGFR L858R OR EGFR Exon 19 Deletion in lung non-small cell carcinoma).

At a glance

  • Status: Approved (max clinical phase 4)
  • Modality: Small molecule
  • ATC class: L01BA04
  • Targets: 3 (DHFR, GART, TYMS)
  • Indications: 64 conditions
  • Clinical trials: 890
  • Precision-oncology evidence (CIViC): 13 variant–indication associations
  • Chemistry: 427.4 Da · C20H21N5O6

Identifiers

Drug identity and classification

FieldValue
ChEMBL IDCHEMBL225072
NamePemetrexed
TypeSmall molecule
Max phase4
FDA approvedyes
PubChem CID135410875
ChEBICHEBI:63616
ATCL01BA04
Molecular formulaC20H21N5O6
Molecular weight427.4
InChIKeyWBXPDJSOTKVWSJ-ZDUSSCGKSA-N

SMILES: C1=CC(=CC=C1CCC2=CNC3=C2C(=O)NC(=N3)N)C(=O)N[C@@H](CCC(=O)O)C(=O)O

IUPAC name: (2S)-2-[[4-[2-(2-amino-4-oxo-3,7-dihydropyrrolo[2,3-d]pyrimidin-5-yl)ethyl]benzoyl]amino]pentanedioic acid

ChEBI definition: An N-acylglutamic acid in which the N-acyl group is specified as 4-[2-(2-amino-4-oxo-4,7-dihydro-1H-pyrrolo[2,3-d]pyrimidin-5-yl)ethyl]benzoyl. Inhibits thymidylate synthase (TS), 421 dihydrofolate reductase (DHFR), and glycinamide ribonucleotide formyltransferase (GARFT).

Pharmacological roles (ChEBI): antineoplastic agent, EC 2.1.1.45 (thymidylate synthase) inhibitor, EC 1.5.1.3 (dihydrofolate reductase) inhibitor, EC 2.1.2.2 (phosphoribosylglycinamide formyltransferase) inhibitor.

Other ChEBI roles (chemical / environmental): antimetabolite.

Also known as: Alimta, LY-231514, LY231514, NSC-698037, Pemetrexed, Pemfexy, pemetrexed, SID124893263, SID50112739, SID525786, PEMETREXED, [3H]-Pemetrexed

Parent form; salt/anhydrous children: CHEMBL2360464, CHEMBL3989962, CHEMBL5315053, CHEMBL6068329, CHEMBL6068335

Patent coverage: 14,919 distinct patent families (55,761 SureChEMBL compound mentions), from 4 matched compound structure(s). One matched structure accounts for 55,151 (99%) of the total. Mentions count patents naming the compound (not distinct inventions), so promiscuous / reference molecules inflate the mention figure — families are the dedup metric.

Targets

Targets

Primary targets (GtoPdb curated mechanism): the Cancer dependency column is the DepMap CRISPR fitness signal (% of screened cell lines dependent on the target).

GeneTargetActionpAffinityCancer dependencyUniProt
DHFRdihydrofolate reductaseInhibition8.1569.8%P00374
GARTphosphoribosylglycinamide formyltransferase, phosphoribosylglycinamide synthetase, phosphoribosylaminoimidazole synthetaseInhibition5.0332.4%P22102
TYMSthymidylate synthetaseInhibition6.9650.8%P04818

Broader ChEMBL bioactivity targets: 19 (assay-derived). Sample: Serine hydroxymethyltransferase, cytosolic, Proton-coupled folate transporter, Dihydrofolate reductase, Thymidylate synthase, Dihydrofolate reductase, Folate receptor alpha, Bifunctional dihydrofolate reductase-thymidylate synthase, Bifunctional purine biosynthesis protein ATIC, Thymidylate synthase, Dihydrofolate reductase.

Bioactivity

ChEMBL activities: 98 potent at pChembl ≥ 5 of 115 total. Top 30 by potency (10 = 0.1 nM, 6 = 1 µM):

TargetpChemblTypeValueUnitActivity ID
TYMS8.89Ki1.3nMCHEMBL_ACT_24862080
TYMS8.89Ki1.3nMCHEMBL_ACT_3465181
DHFR8.15Ki7nMCHEMBL_ACT_1495527
DHFR8.14Ki7.2nMCHEMBL_ACT_24862081
DHFR8.14Ki7.2nMCHEMBL_ACT_3465182
SLC46A18.08IC508.3nMCHEMBL_ACT_18863169
GART7.93IC5011.74nMCHEMBL_ACT_15200056
SLC46A17.88IC5013.2nMCHEMBL_ACT_15067597
SLC46A17.88IC5013.2nMCHEMBL_ACT_15200019
SLC46A17.88IC5013.2nMCHEMBL_ACT_18527797
SLC19A17.62IC5023.8nMCHEMBL_ACT_18863181
SLC19A17.58IC5026.2nMCHEMBL_ACT_18863118
GART7.54IC5029.2nMCHEMBL_ACT_18863348
GART7.52IC5030nMCHEMBL_ACT_2228903
GART7.52IC5030nMCHEMBL_ACT_2527328
FOLR17.38IC5042nMCHEMBL_ACT_15072119
FOLR17.38IC5042nMCHEMBL_ACT_15200011
FOLR17.38IC5042nMCHEMBL_ACT_18527753
FOLR17.38IC5042nMCHEMBL_ACT_18863143
FRK7.38IC5042nMCHEMBL_ACT_29103813
FOLR27.22IC5060nMCHEMBL_ACT_15072101
FOLR27.22IC5060nMCHEMBL_ACT_18527775
FOLR27.22IC5060nMCHEMBL_ACT_18863156
GART7.19Ki65nMCHEMBL_ACT_24862082
SLC46A17.17IC5066.8nMCHEMBL_ACT_18863193
DHFR7.17IC5068nMCHEMBL_ACT_20685614
TYMS7.16IC5070nMCHEMBL_ACT_18314595
SLC46A17.03Ki94nMCHEMBL_ACT_12078936
SLC46A17.03Ki94nMCHEMBL_ACT_19443032
SLC46A17.02Ki96nMCHEMBL_ACT_3101242

Target pathways

Aggregated over 3 target gene(s): DHFR, GART, TYMS.

Top Reactome pathways

5 total, by targets touching each:

PathwayTargetsGenes
G1/S-Specific Transcription2DHFR, TYMS
Tetrahydrobiopterin (BH4) synthesis, recycling, salvage and regulation1DHFR
Metabolism of folate and pterines1DHFR
Interconversion of nucleotide di- and triphosphates1TYMS
Purine ribonucleoside monophosphate biosynthesis1GART

Dominant GO biological processes

GO termTargets
one-carbon metabolic process2
negative regulation of translation2
tetrahydrofolate metabolic process2
tetrahydrobiopterin biosynthetic process1
axon regeneration1
response to methotrexate1
dihydrofolate metabolic process1
tetrahydrofolate biosynthetic process1
folic acid metabolic process1
regulation of removal of superoxide radicals1
brainstem development1
purine nucleotide biosynthetic process1
GMP biosynthetic process1
‘de novo’ IMP biosynthetic process1
purine ribonucleoside monophosphate biosynthetic process1

Indications & clinical

Indications

64 indications (5 at ChEMBL trial phase 4). Phase below is the highest clinical-trial phase recorded for this drug against each disease — not the molecule’s overall approval status (that is in the Summary).

IndicationTrial phaseMONDOEFO
neoplasm4MONDO:0005070EFO:0000616
mesothelioma4MONDO:0005065EFO:0000588
malignant pleural mesothelioma4MONDO:0005112EFO:0000770
malignant peritoneal mesothelioma4MONDO:0005512EFO:0005567
non-small cell lung carcinoma3MONDO:0005233EFO:0003060
gastric carcinoma3MONDO:0004950EFO:0000178
carcinoma3MONDO:0004993EFO:0000313
lung adenocarcinoma3MONDO:0005061EFO:0000571
small cell lung carcinoma3MONDO:0008433EFO:0000702
gastric neoplasm3MONDO:0021085EFO:0003897
upper aerodigestive tract neoplasm3MONDO:0005398EFO:0004284
head and neck cancer3MONDO:0005627EFO:0006859
lung neoplasm3MONDO:0021117MONDO:0008903
cervical adenocarcinoma3MONDO:0005153EFO:0001416
head and neck squamous cell carcinoma2MONDO:0010150EFO:0000181
adenocarcinoma2MONDO:0004970EFO:0000228
osteosarcoma2MONDO:0009807EFO:0000637
renal cell carcinoma2MONDO:0005086EFO:0000681
sarcoma2MONDO:0005089EFO:0000691
squamous cell lung carcinoma2MONDO:0005097EFO:0000708
exocrine pancreatic carcinoma2MONDO:0005192EFO:0002618
carcinoma of esophagus2MONDO:0019086EFO:0002916
medulloblastoma2MONDO:0007959EFO:0002939
breast neoplasm2MONDO:0021100EFO:0003869
colorectal neoplasm2MONDO:0005335EFO:0004142
nasopharyngeal neoplasm2MONDO:0005375EFO:0004252
male breast carcinoma2MONDO:0005628EFO:0006861
urothelial carcinoma2MONDO:0040679EFO:0008528
rectal cancer2MONDO:0006519EFO:1000657
neuroendocrine neoplasm2MONDO:0019496EFO:1001901
peritoneal neoplasm2MONDO:0006901MONDO:0002087
fallopian tube neoplasm2MONDO:0021092MONDO:0002158
ovarian cancer2MONDO:0008170MONDO:0008170
ovarian carcinoma2MONDO:0005140EFO:0001075
fallopian tube carcinoma2MONDO:0006206EFO:1000251
diffuse large B-cell lymphoma2MONDO:0018905EFO:0000403
lung large cell carcinoma2MONDO:0003050EFO:0003050
malignant mesothelioma2MONDO:0006292EFO:1000355
lymphoma1MONDO:0005062EFO:0000574
non-Hodgkin lymphoma1MONDO:0018908EFO:0005952
thymoma1MONDO:0006456EFO:1000581
metastatic melanoma1MONDO:0005191EFO:0002617
chordoma1MONDO:0008978MONDO:0008978
endometrium neoplasm1MONDO:0021251MONDO:0011962
primary myelofibrosis1MONDO:0009692MONDO:0044903
triple-negative breast carcinoma1MONDO:0005494EFO:0005537
uveal melanoma1MONDO:0006486EFO:1000616
glioma0MONDO:0021042MONDO:0100342

16 further indication records had no mapped disease name (EFO/MeSH-only) or were duplicates, and are omitted.

Clinical trials

Total trials: 890.

Phase distribution

PhaseTrials
PHASE2420
PHASE3188
PHASE1139
PHASE1/PHASE282
Not specified24
PHASE2/PHASE320
PHASE413
EARLY_PHASE14

Top trials by phase / activity

NCTPhaseStatusTitle
NCT05689671PHASE4ACTIVE_NOT_RECRUITINGPemetrexed-free vs. Pemetrexed-based Immunochemotherapy in Metastatic TTF-1 Negative Lung Adenocarcinoma
NCT00380718PHASE4COMPLETEDChemotherapy for Patients With Non-Small Cell Lung Cancer
NCT01020786PHASE4COMPLETEDA Study in Non-squamous Non Small Cell Lung Cancer in Asian Patients
NCT01442909PHASE4COMPLETEDPemetrexed Followed by Docetaxel or in Reverse Sequence
NCT02031601PHASE4UNKNOWNIntercalated Combination of Chemotherapy and Tyrosine Kinase Inhibitors as First-line Treatment for Patients With Non-Small-Cell Lung Cancer
NCT02399566PHASE4UNKNOWNClinical Trial of Erlotinib and Pemetrexed for Maintenance Treatment in Lung Adenocarcinoma
NCT03460678PHASE4TERMINATEDRandomized Comparative Study of Erlotinib and Pemetrexed in the Maintenance Treatment of Advanced Lung Cancer Patients.
NCT03607149PHASE4COMPLETEDPemetrexed in Maintenance in Patients With Impaired Renal Function, 2 Dose Calculation Strategies
NCT03655821PHASE4TERMINATEDDose Individualization of Pemetrexed - IMPROVE-II
NCT03655834PHASE4COMPLETEDDose Individualization of Pemetrexed - IMPROVE-III
NCT03656549PHASE4COMPLETEDDose Individualization of Pemetrexed - IMPROVE-I
NCT03768037PHASE4UNKNOWNAnlotinib Plus Pemetrexed or Pemetrexed for Previously Untreated Elderly (>=70) or PS=2 Non-squamous NSCLC
NCT03792503PHASE4WITHDRAWNPemetrexed Plus Apatinib Maintenance Treatment in Patients With Non-squamous Non-small Cell Lung Cancer Patients Who Have Not Progressed After 4 Cycles of Induction Chemotherapy of Pemetrexed in Combination With Platinum-based Regimen
NCT02453282PHASE3ACTIVE_NOT_RECRUITINGPhase III Open Label First Line Therapy Study of MEDI 4736 (Durvalumab) With or Without Tremelimumab Versus SOC in Non Small-Cell Lung Cancer (NSCLC)
NCT02486718PHASE3ACTIVE_NOT_RECRUITINGStudy to Assess Safety and Efficacy of Atezolizumab (MPDL3280A) Compared to Best Supportive Care Following Chemotherapy in Patients With Lung Cancer [IMpower010]
NCT02542293PHASE3ACTIVE_NOT_RECRUITINGStudy of Durvalumab With Tremelimumab Versus SoC as 1st Line Therapy in Metastatic Non Small-Cell Lung Cancer (NSCLC) (NEPTUNE)
NCT03003962PHASE3ACTIVE_NOT_RECRUITINGStudy of Durvalumab Alone or Chemotherapy for Patients With Advanced Non Small-Cell Lung Cancer (PEARL)
NCT03164616PHASE3ACTIVE_NOT_RECRUITINGStudy of Durvalumab + Tremelimumab With Chemotherapy or Durvalumab With Chemotherapy or Chemotherapy Alone for Patients With Lung Cancer (POSEIDON).
NCT03178552PHASE2/PHASE3ACTIVE_NOT_RECRUITINGA Study to Evaluate the Efficacy and Safety of Multiple Targeted Therapies as Treatments for Participants With Non-Small Cell Lung Cancer (NSCLC)
NCT03425643PHASE3ACTIVE_NOT_RECRUITINGEfficacy and Safety of Pembrolizumab (MK-3475) With Platinum Doublet Chemotherapy as Neoadjuvant/Adjuvant Therapy for Participants With Resectable Stage II, IIIA, and Resectable IIIB (T3-4N2) Non-small Cell Lung Cancer (MK-3475-671/KEYNOTE-671)
NCT03456076PHASE3ACTIVE_NOT_RECRUITINGA Study Comparing Adjuvant Alectinib Versus Adjuvant Platinum-Based Chemotherapy in Patients With ALK Positive Non-Small Cell Lung Cancer
NCT03519971PHASE3ACTIVE_NOT_RECRUITINGStudy of Durvalumab Given With Chemoradiation Therapy in Patients With Unresectable Non-small Cell Lung Cancer
NCT03768063PHASE3ACTIVE_NOT_RECRUITINGA Study in Patients Previously Enrolled in a Genentech and/or F. Hoffmann-La Roche Ltd Sponsored Atezolizumab Study
NCT03793179PHASE3ACTIVE_NOT_RECRUITINGTesting the Timing of Pembrolizumab Alone or With Chemotherapy as First Line Treatment and Maintenance in Non-small Cell Lung Cancer
NCT03800134PHASE3ACTIVE_NOT_RECRUITINGA Study of Neoadjuvant/Adjuvant Durvalumab for the Treatment of Patients With Resectable Non-small Cell Lung Cancer
NCT04025879PHASE3ACTIVE_NOT_RECRUITINGA Study of Neoadjuvant Chemotherapy Plus Nivolumab Versus Neoadjuvant Chemotherapy Plus Placebo, Followed by Surgical Removal and Adjuvant Treatment With Nivolumab or Placebo for Participants With Surgically Removable Early Stage Non-small Cell Lung Cancer
NCT04035486PHASE3ACTIVE_NOT_RECRUITINGA Study of Osimertinib With or Without Chemotherapy as 1st Line Treatment in Patients With Mutated Epidermal Growth Factor Receptor Non-Small Cell Lung Cancer (FLAURA2)
NCT04129502PHASE3ACTIVE_NOT_RECRUITINGTAK-788 as First-Line Treatment Versus Platinum-Based Chemotherapy for Non-Small Cell Lung Cancer (NSCLC) With EGFR Exon 20 Insertion Mutations
NCT04194944PHASE3ACTIVE_NOT_RECRUITINGA Study of Selpercatinib (LY3527723) in Participants With Advanced or Metastatic RET Fusion-Positive Non-Small Cell Lung Cancer
NCT04205812PHASE3ACTIVE_NOT_RECRUITINGPlatinum-Based Chemotherapy With/Without INCMGA00012, an Anti-PD-1 Antibody, in Non-Small Cell Lung Cancer
NCT04339218PHASE3RECRUITINGCryoablation in Combination (or Not) With Pembrolizumab and Pemetrexed-carboplatin in 1st-line Treatment for Patients With Metastatic Lung Adenocarcinoma
NCT04351555PHASE3ACTIVE_NOT_RECRUITINGA Study of Osimertinib With or Without Chemotherapy Versus Chemotherapy Alone as Neoadjuvant Therapy for Patients With EGFRm Positive Resectable Non-Small Cell Lung Cancer
NCT04380636PHASE3ACTIVE_NOT_RECRUITINGStudy of Pembrolizumab With Concurrent Chemoradiation Therapy Followed by Pembrolizumab With or Without Olaparib in Stage III Non-Small Cell Lung Cancer (NSCLC) (MK-7339-012/KEYLYNK-012)
NCT04538664PHASE3ACTIVE_NOT_RECRUITINGA Study of Combination Amivantamab and Carboplatin-Pemetrexed Therapy, Compared With Carboplatin-Pemetrexed, in Participants With Advanced or Metastatic Non-Small Cell Lung Cancer Characterized by Epidermal Growth Factor Receptor (EGFR) Exon 20 Insertions
NCT04585490PHASE3RECRUITINGPersonalized Escalation of Consolidation Treatment Following Chemoradiotherapy and Immunotherapy in Stage III NSCLC in Stage III NSCLC
NCT04695925PHASE3ACTIVE_NOT_RECRUITINGOsimertinib Monotherapy or Combination With Chemotherapy for Advanced NSCLC Concurrent EGFR and TP53 Mutations
NCT04762459PHASE3ENROLLING_BY_INVITATIONEfficacy and Safety of Almonertinib Combined With or Without Chemotherapy as an Adjuvant Treatment for Stage II-IIIA Non-small Cell Lung Carcinoma Following Complete Tumour Resection
NCT04956692PHASE3ACTIVE_NOT_RECRUITINGStudy of Pembrolizumab (MK-3475) Subcutaneous (SC) Versus Pembrolizumab Intravenous (IV) Administered With Platinum Doublet Chemotherapy in Participants With Metastatic Squamous or Nonsquamous Non-Small Cell Lung Cancer (NSCLC) (MK-3475-A86)
NCT04988295PHASE3ACTIVE_NOT_RECRUITINGA Study of Amivantamab and Lazertinib in Combination With Platinum-Based Chemotherapy Compared With Platinum-Based Chemotherapy in Patients With Epidermal Growth Factor Receptor (EGFR)-Mutated Locally Advanced or Metastatic Non- Small Cell Lung Cancer After Osimertinib Failure
NCT05048797PHASE3ACTIVE_NOT_RECRUITINGA Study to Investigate the Efficacy and Safety of Trastuzumab Deruxtecan as the First Treatment Option for Unresectable, Locally Advanced/Metastatic Non-Small Cell Lung Cancer With HER2 Mutations

Clinical evidence (CIViC)

Variant × indication × effect (13 predictive associations from 14 curated evidence items):

VariantIndicationEffectTherapyLevelCIViC
EGFR L858R OR EGFR Exon 19 DeletionLung Non-small Cell CarcinomaSensitivity/ResponseCarboplatin + Pemetrexed + AmivantamabCIViC AEID12156
ALK FusionLung Non-small Cell CarcinomaSensitivity/ResponsePemetrexedCIViC BEID945
EGFR MutationLung Non-small Cell CarcinomaSensitivity/ResponsePemetrexed + GefitinibCIViC BEID7650
KRAS MutationLung Non-small Cell CarcinomaSensitivity/ResponsePemetrexed + Docetaxel + TrametinibCIViC BEID4862
MTAP DeletionBladder Urothelial CarcinomaSensitivity/ResponsePemetrexedCIViC BEID12722
MTAP Underexpression AND CDKN2A UnderexpressionLung AdenocarcinomaSensitivity/ResponsePemetrexedCIViC BEID12723
TYMS UnderexpressionLung Non-small Cell CarcinomaSensitivity/ResponsePemetrexedCIViC BEID907
TYMS OverexpressionLung Non-small Cell CarcinomaResistancePemetrexedCIViC BEID832 +1
MDM2 EXPRESSIONMalignant Pleural MesotheliomaResistancePemetrexed + CisplatinCIViC BEID827
TYMS AmplificationLung AdenocarcinomaResistancePemetrexedCIViC BEID903
EGFR T790MLung Non-small Cell CarcinomaSensitivity/ResponseErlotinib + PemetrexedCIViC CEID277
MET Exon 14 Skipping Mutation AND CD274 OverexpressionLung AdenocarcinomaSensitivity/ResponseCarboplatin + PemetrexedCIViC CEID11397
TYMS UnderexpressionProstate CancerSensitivity/ResponsePemetrexedCIViC CEID908

Pharmacology

Pharmacogenomics

No PharmGKB pharmacogenomic data curated for this drug.

Molecules sharing ≥1 of this drug’s curated primary targets, merged from two biobtree sources and ranked by shared-target count, then clinical phase: ChEMBL clinical-stage candidates (development phase ≥2) and PubChem drug-class bioactivity (approved / known drugs acting on the target). Deduplicated by drug name; the drug’s own salt forms are excluded. Note: for a drug with few primary targets a shared-target match can reflect off-target / promiscuous binding rather than the same therapeutic mechanism — the phase ordering surfaces bona-fide therapeutics first.

28 molecules share ≥1 primary target. Top 28 by shared-target count:

MoleculeSourceStatusShared targets
METHOTREXATEChEMBL + PubChemPhase 4 (approved)DHFR, GART, TYMS
Folic AcidChEMBL + PubChemPhase 4 (approved)DHFR, TYMS
PRALATREXATEChEMBL + PubChemPhase 4 (approved)DHFR, GART
RALTITREXEDChEMBLPhase 4 (approved)DHFR, TYMS
LEUCOVORINChEMBL + PubChemPhase 4 (approved)DHFR
DIFLUNISALChEMBLPhase 4 (approved)DHFR
GENTAMICINChEMBLPhase 4 (approved)DHFR
MEFENAMIC ACIDChEMBLPhase 4 (approved)DHFR
PHENOLPHTHALEINChEMBLPhase 4 (approved)TYMS
PYRIMETHAMINEChEMBLPhase 4 (approved)DHFR
SULFACETAMIDEChEMBLPhase 4 (approved)DHFR
SULFADIAZINEChEMBLPhase 4 (approved)DHFR
TERIFLUNOMIDEChEMBLPhase 4 (approved)DHFR
TRIMETHOPRIMChEMBLPhase 4 (approved)DHFR
TRIMETREXATEChEMBLPhase 4 (approved)DHFR
ICLAPRIMChEMBLPhase 3DHFR
NOLATREXEDChEMBLPhase 3TYMS
AMINOPTERINChEMBLPhase 2DHFR
BREQUINARChEMBLPhase 2DHFR
CYCLOGUANILChEMBLPhase 2DHFR
DIAVERIDINEChEMBLPhase 2DHFR
EDATREXATEChEMBLPhase 2DHFR
EPIROPRIMChEMBLPhase 2DHFR
LOMETREXOLChEMBLPhase 2GART
METESINDChEMBLPhase 2TYMS
OSI-7904ChEMBLPhase 2TYMS
PIRITREXIMChEMBLPhase 2DHFR
Pemetrexed DisodiumPubChemApprovedTYMS