cisplatin + pegargiminase + pemetrexed

This is a combination regimen of three drugs—cisplatin, pegargiminase (also known as ADI-PEG20), and pemetrexed—used primarily in the treatment of certain cancers characterized by argininosuccinate synthetase 1 (ASS1) deficiency. - **Cisplatin** is a platinum-based chemotherapy agent that causes DNA crosslinking and apoptosis in rapidly dividing cells. - **Pegargiminase** (ADI-PEG20) is a pegylated recombinant enzyme that depletes extracellular arginine by converting it to citrulline and ammonia; this exploits the metabolic vulnerability of ASS1-deficient tumors, which cannot synthesize arginine de novo. - **Pemetrexed** is an antifolate antimetabolite that inhibits several folate-dependent enzymes involved in purine and pyrimidine synthesis, thereby blocking DNA replication and cell division[6][8][10]. The combination has been studied for its synergistic effects in ASS1-deficient cancers such as malignant pleural mesothelioma (especially non-epithelioid subtype) and metastatic uveal melanoma[2][3][4][5]. Pegargiminase sensitizes tumor cells to antifolate chemotherapy by suppressing thymidine synthesis pathways[3]. Clinical trials have shown improved disease control rates and overall survival compared to standard regimens for these indications.

Other names

cisplatin + ADI-PEG20 + pemetrexedcisplatin + arginine deiminase (pegylated) + pemetrexed