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Raltitrexed, sometimes sold under the brand name Tomudex, is a chemotherapy drug approved for use in bowel cancer patients but used to treat other cancers as well.[1] It is of the category of chemotherapy drugs known as anti-metabolites, similar to pemetrexed.[2]
Like pemetrexed, raltitrexed mimics a folate-containing molecule that encourages its absorption by cancer cells. Once in the cell, it interferes with enzymes that bind to folate during the process of DNA replication and repair. This effect inhibits cellular duplication, causing cancer cell death.[3]
Raltitrexed is still actively being explored for use as a chemotherapy agent, as it was just recently developed in the mid 2000s.[4] It is most often administered via IV.
Use of raltitrexed can also make cancer cells more sensitive to radiation, allowing radiation therapy to more effectively target and kill cancer cells while reducing the needed dose.[5],[6]
Physicians may prescribe raltitrexed in patients for which cardiac toxicity is a concern because the drug appears to have less adverse effects compared to other chemotherapy alternatives.[7]
Raltitrexed is especially common for the treatment of colorectal cancers.[8] Trials have revealed the drug’s potential as a first-line treatment for malignant mesothelioma, particularly in combination with oxaliplatin.[9] Raltitrexed has also shown to be effective in combination with cisplatin, providing improved survivability for patients compared to use of cisplatin alone.[10]
Common side effects of raltitrexed include[11]:
- Rash
- Stomach pain
- Diarrhea
- Nausea and vomiting
- Weight loss
- Loss of appetite
- Fatigue
- Constipation
- Mouth sores
- Joint pain
- Cough
[1] https://www.macmillan.org.uk/information-and-support/treating/chemotherapy/drugs-and-combination-regimens/individual-drugs/raltitrexed.html
[2] https://www.cancerresearchuk.org/about-cancer/cancer-in-general/treatment/cancer-drugs/drugs/raltitrexed
[3] https://pubchem.ncbi.nlm.nih.gov/compound/Raltitrexed
[4] https://dtb.bmj.com/content/34/10/78
[5] http://www.bccancer.bc.ca/drug-database-site/Drug%20Index/Raltitrexed_monograph_1June2013_formatted.pdf
[6] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4270009/
[7] https://www.medscape.com/viewarticle/820460
[8] https://academic.oup.com/annonc/article/13/4/513/212160
[9] https://www.ncbi.nlm.nih.gov/pubmed/12056700
[10] https://www.ncbi.nlm.nih.gov/pubmed/16192580
[11] https://www.cancercareontario.ca/sites/ccocancercare/files/raltitrexed.pdf
