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A combination chemotherapy regimen consisting of pemetrexed and temozolomide. Pemetrexed is an antifolate antineoplastic agent that inhibits multiple enzymes in the folate pathway, including thymidylate synthase, dihydrofolate reductase, and glycinamide ribonucleotide formyltransferase. Temozolomide is an oral alkylating agent that readily crosses the blood-brain barrier, achieving cerebrospinal fluid concentrations approximately 30% of plasma concentrations. This combination has been studied primarily for the treatment of brain metastases in non-small cell lung cancer (NSCLC) and other central nervous system malignancies.
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