Pemetrexed for ovarian cancer: A systematic review of the published literature and a consecutive series of patients treated in a nonclinical trial setting

Objective: To gain a better understanding of the role of pemetrexed in ovarian cancer patients, we conducted a systematic review of the published literature and evaluated a consecutive, single-institution series of non-study pemetrexed-treated patients. Methods/Results: Thirteen published articles met this study's eligibility criteria, providing a total of 376 unique and evaluable ovarian cancer patients. This systematic review demonstrated tumor response rates with pemetrexed-based chemotherapy from 9 to 84%; the agent appeared to be well tolerated. Similarly, 13 consecutive patients with ovarian, fallopian tube, or primary peritoneal cancer were treated with pemetrexed at the Mayo Clinic, Rochester, Minn., USA, from 2004 through 2013. The median number of previous chemotherapy regimens was 4; most patients received single-agent pemetrexed (n = 9). Patients received a median of 2 cycles of pemetrexed-based chemotherapy; 1 patient received 10 cycles (7 months' worth) with treatment ongoing at the time of this report. The median survival from the start of pemetrexed was 4.8 months (95% confidence interval 1.2, 15 months). Two patients manifested a 50% drop in Ca-125 levels. Again, pemetrexed was relatively well tolerated. Conclusion: Pemetrexed has antineoplastic activity in patients with ovarian cancer - even among those who have been heavily pretreated - and therefore merits further study.