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Iruplaltinib + pemetrexed is a combination therapy being investigated for the treatment of anaplastic lymphoma kinase (ALK)-positive non-small cell lung cancer (NSCLC). The combination consists of **iruplaltinib** (also known as iruplinalkib), a potent, oral, small-molecule tyrosine kinase inhibitor (TKI) that selectively targets ALK and ROS1 rearrangements, and **pemetrexed**, a standard-of-care antifolate chemotherapy agent. Iruplaltinib, developed by Qilu Pharmaceutical, works by inhibiting the phosphorylation of ALK and its downstream signaling pathways, which are critical for the survival and proliferation of ALK-positive tumor cells. Pemetrexed disrupts folate-dependent metabolic processes essential for DNA and RNA synthesis by inhibiting thymidylate synthase (TS), dihydrofolate reductase (DHFR), and glycinamide ribonucleotide formyltransferase (GARFT). This combination is specifically being evaluated in Phase 2 clinical trials as a neoadjuvant therapy for patients with resectable ALK-positive non-squamous NSCLC to improve surgical outcomes and long-term survival.
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