Methotrexate and Pralatrexate

Dermatol Clin. 2015 Oct;33(4):747-55. doi: 10.1016/j.det.2015.05.009. Epub 2015 Aug 1.

Abstract

This article reviews methotrexate and the more potent, related compound, pralatrexate, for the treatment of cutaneous T-cell lymphomas, including mycosis fungoides, Sézary syndrome, and CD30+ lymphoproliferative disorders. Although these folate antagonists are traditionally viewed as antiproliferative cell cycle inhibitors, it is recognized that they inhibit DNA methylation, providing a rationale for their use as epigenetic regulators and cell proliferation inhibitors. The underlying mechanisms are outlined, key supporting data presented, followed by brief mention of recent mathematical modeling supporting the general superiority of combination therapy. Several novel examples involving folate antagonists are proposed.

Keywords: Apoptosis; Dihydrofolate reductase; Folate; Folic acid; Methotrexate; Pralatrexate; Purine synthesis; S phase.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Aminopterin / adverse effects
  • Aminopterin / analogs & derivatives*
  • Aminopterin / pharmacology
  • Aminopterin / therapeutic use
  • Antimetabolites, Antineoplastic / adverse effects
  • Antimetabolites, Antineoplastic / pharmacology
  • Antimetabolites, Antineoplastic / therapeutic use*
  • Apoptosis / drug effects
  • DNA Methylation / drug effects
  • Epigenesis, Genetic / drug effects
  • Folic Acid Antagonists / adverse effects
  • Folic Acid Antagonists / pharmacology
  • Folic Acid Antagonists / therapeutic use*
  • Humans
  • Lymphoma, T-Cell, Cutaneous / drug therapy*
  • Methotrexate / adverse effects
  • Methotrexate / pharmacology
  • Methotrexate / therapeutic use*
  • S Phase / drug effects
  • Skin Neoplasms / drug therapy*

Substances

  • 10-propargyl-10-deazaaminopterin
  • Antimetabolites, Antineoplastic
  • Folic Acid Antagonists
  • Aminopterin
  • Methotrexate