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Pazopanib + pemetrexed is a combination of two antineoplastic agents that was investigated for the treatment of advanced non-small cell lung cancer (NSCLC). Pazopanib is a small molecule tyrosine kinase inhibitor targeting vascular endothelial growth factor receptor 1 (VEGFR-1), vascular endothelial growth factor receptor 2 (VEGFR-2), vascular endothelial growth factor receptor 3 (VEGFR-3), platelet-derived growth factor receptor alpha, platelet-derived growth factor receptor beta, and c-kit. It inhibits angiogenesis required for tumor survival and growth. Pemetrexed is an antifolate chemotherapy agent that disrupts folate-dependent metabolic processes essential for cell replication by inhibiting enzymes such as thymidylate synthase (TS), dihydrofolate reductase (DHFR), and glycinamide ribonucleotide formyltransferase (GARFT). Clinical trials combining these drugs in NSCLC showed some antitumor activity but were terminated early due to unacceptable toxicity and increased mortality[1][2][3][4].
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