ABSTRACT
Malignant mesothelioma is an aggressive malig na ncy that may be caused by environmental carcinogens(asbestos),viruses(SV40),and genetic predisposition.Diagnosis relies on radiographic studies as well as patho logy and mdecular bidogy tests.Most such patients are not suitable for surgical or radiotherapy treatment,and cytotoxic agents are the only options.Historically ,no single or combinations of agents consistently yielded response rates over 20 %.Recently,pemetrexed,a folate-based inhibitor of thymidylate synthase,has been evaluated in phase Ⅰ,ⅡandⅢ clinical trials with promising results.Moreover, low-dose folic acid and vitamin B 12 supplementation significantly reduced the toxicity observed with the use of pemetrexed.In light of these data,it is l ikely that pemetrexed/cisplatin will soon be recommended for malignant pleural m esothelioma as first-line standard chemotherapy.