Common brand names

• Folotyn

How it is administered

Pralatrexate is given as an intravenous (IV) injection. It is supplied as a clear yellow solution in single-dose vials, with each 1 mL containing 20 mg of pralatrexate. The medication is administered by a healthcare professional directly into a vein over 3 to 5 minutes, usually once weekly for 6 weeks in a 7-week cycle. The dose may be adjusted based on your kidney function and how well you tolerate the medication.

Before starting pralatrexate, patients should take folic acid by mouth daily and receive vitamin B12 injections every 8-10 weeks to help reduce side effects.

How it works

Pralatrexate is a type of chemotherapy known as a folate analog metabolic inhibitor. It works by blocking an enzyme called dihydrofolate reductase, which is necessary for cells to make DNA and other important molecules. By inhibiting this enzyme, pralatrexate prevents cancer cells from growing and dividing.

In addition, pralatrexate interferes with another enzyme involved in the processing of folate within cells, further reducing the ability of cancer cells to produce the building blocks they need to survive. This dual action helps to slow down or stop the growth of certain types of blood cancers, especially those involving T-cells.

Who should take it

Pralatrexate is indicated for adults with relapsed or refractory peripheral T-cell lymphoma (PTCL), a type of blood cancer that affects T-cells. It is used when the disease has returned after previous treatments or has not responded to other therapies.

If you have Adult T-cell Leukemia/Lymphoma (ATLL), your doctor may consider pralatrexate if your disease is similar to PTCL and has not responded to standard treatments. The decision to use pralatrexate should be made by your healthcare provider based on your specific type of cancer, previous treatments, and overall health.

Who should not take it

There are no absolute contraindications listed for pralatrexate, meaning there are no specific situations where it should never be used. However, certain patients should use caution:

• If you have severe kidney problems (end stage renal disease), pralatrexate should generally be avoided unless the potential benefits outweigh the risks, as it can increase toxicity.
• Pralatrexate can cause harm to an unborn baby, so it should not be used during pregnancy. Effective contraception is recommended for both men and women during treatment and for several months after the last dose.
• If you are breastfeeding, you should not breastfeed during treatment and for at least 1 week after the last dose.

Always inform your healthcare provider about all your medical conditions and medications before starting pralatrexate.

Commonly used with

Pralatrexate is often used alone for relapsed or refractory PTCL, but patients are required to take folic acid and vitamin B12 supplements to help reduce the risk of side effects. These supplements are started before treatment and continued during and after therapy.

Other supportive medications, such as drugs to prevent infection or manage side effects (like anti-nausea medications), may also be used alongside pralatrexate.

Commonly tested with

In clinical studies, pralatrexate has primarily been tested as a single agent in patients with relapsed or refractory peripheral T-cell lymphoma. However, it may be studied in combination with other chemotherapy agents or supportive care drugs in research settings.

Your doctor may recommend additional medications or supportive therapies based on your individual needs and the side effects you experience during treatment.