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See also Cytotoxic and immunosuppressant drugs
Raltitrexed is a specific inhibitor of thymidylate synthase. It is used to treat colorectal cancers.
In about 1000 patients with advanced colorectal cancer, the dose-limiting toxic effects in phase 1 studies were gastrointestinal toxicity, myelosuppression, and weakness; adverse events during phase 2 and 3 studies were similar to those seen during phase 1 [ ]. In all comparative studies, mucositis and leukopenia were markedly less common and less severe in patients treated with raltitrexed than with bolus fluorouracil + leucovorin. Thrombocytopenia was more common with raltitrexed but it was not associated with an increase in clinically significant hemorrhage. In contrast, raltitrexed-related myelosuppression was more severe than with fluorouracil + leucovorin when the anti-metabolite was given by continuous infusion. Raised aminotransferase activities were common with raltitrexed but were usually reversible with continued dosing and were not associated with clinical sequelae.
In 21 patients with advanced colorectal cancer, intravenous raltitrexed 3 mg/m 2 plus mitomycin 6 mg/m 2 was associated with WHO grade 3/4 anemia in two, and neutropenia and thrombocytopenia in one each [ ].
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