Antifolates: the next generation

Semin Oncol. 1992 Dec;19(6):707-19.

Abstract

A number of promising new antifolates have been entered in clinical trials in recent years. These agents have been rationally designed based on the current understanding of folate transport and metabolism and of the mechanisms by which cells become resistant to methotrexate. Methotrexate-resistant cell lines are generally sensitive to one or more of the newer antifolates, which differ from methotrexate by being either more lipid soluble, more extensively polyglutamated, or by inhibiting folate-requiring enzymes other than dihydrofolate reductase. Five of the agents furthest along in clinical testing, trimetrexate, piritrexim, edatrexate, lometrexol, and D1694, are discussed. These drugs offer exciting opportunities to expand the role of antifolates in cancer chemotherapy, as well as in antimicrobial and antirheumatic therapy.

Publication types

  • Review

MeSH terms

  • Aminopterin / analogs & derivatives
  • Aminopterin / therapeutic use
  • Animals
  • Antineoplastic Agents / chemistry
  • Antineoplastic Agents / therapeutic use*
  • Chemistry, Pharmaceutical
  • Clinical Trials as Topic
  • Drug Evaluation
  • Folic Acid Antagonists / chemistry
  • Folic Acid Antagonists / therapeutic use*
  • Forecasting
  • Humans
  • Neoplasms / drug therapy
  • Pyrimidines / therapeutic use
  • Quinazolines / therapeutic use
  • Tetrahydrofolates / therapeutic use
  • Thiophenes / therapeutic use
  • Trimetrexate / therapeutic use

Substances

  • Antineoplastic Agents
  • Folic Acid Antagonists
  • Pyrimidines
  • Quinazolines
  • Tetrahydrofolates
  • Thiophenes
  • lometrexol
  • raltitrexed
  • edatrexate
  • Aminopterin
  • piritrexim
  • Trimetrexate