# Pralatrexate

Source: https://onco.cc/drugs/pralatrexate/  
OnCo record `pralatrexate` (Treatment). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Pralatrexate was the first drug approved specifically for relapsed peripheral T-cell lymphoma; about a third of patients respond.

## Summary

Pralatrexate is a folate analogue with high affinity for the reduced folate carrier RFC-1 and efficient polyglutamylation, so it accumulates selectively in tumour cells and inhibits dihydrofolate reductase. It is given intravenously to patients with relapsed or refractory peripheral T-cell lymphoma, a group with few options. The single-arm PROPEL study (2009) showed a 29% response rate in heavily pretreated PTCL and supported accelerated US approval in 2009, the first drug licensed specifically for this indication; it is also approved in Japan and China. Mucositis is the dose-limiting toxicity and is mitigated by folate and vitamin B12 supplementation. It offers durable responses in a minority rather than a cure, without randomised survival data. For a newcomer, pralatrexate is a targeted antifolate that helps about a third of relapsed T-cell lymphoma patients.

## Fields

- Kind: Treatment
- Status: approved
- Last checked: 2026-09-08
- Tags: gap-fill
- Brand: Folotyn
- Modality: Antifolate (DHFR inhibitor)
- Mechanism: Folate analogue with high affinity for the reduced folate carrier (RFC-1) and efficient polyglutamylation, selectively accumulating in tumour cells and inhibiting DHFR.
- Approvals: US 2009: Relapsed/refractory peripheral T-cell lymphoma

## Sources

- Wikipedia: https://en.wikipedia.org/wiki/Pralatrexate
- Label (DailyMed): https://dailymed.nlm.nih.gov/dailymed/search.cfm?labeltype=all&query=pralatrexate

## Connected records

- cancers: [Nodal T-follicular helper cell lymphoma, angioimmunoblastic type (angioimmunoblastic T-cell lymphoma)](https://onco.cc/cancers/angioimmunoblastic-t-cell-lymphoma/), [Peripheral T-cell lymphomas (including cutaneous T-cell lymphoma)](https://onco.cc/cancers/peripheral-t-cell-lymphoma/), [Sezary syndrome](https://onco.cc/cancers/sezary-syndrome/)
- technologies: [Cytotoxic chemotherapy](https://onco.cc/technologies/cytotoxic-chemotherapy/)
- companies: [Acrotech Biopharma](https://onco.cc/companies/acrotech-biopharma/), [Mundipharma](https://onco.cc/companies/mundipharma/), [Spectrum Pharmaceuticals](https://onco.cc/companies/spectrum-pharmaceuticals/)
- trials: [Randomized Phase IIB Trial of Oral Azacytidine Plus Romidepsin Versus Investigator's Choice in PTCL](https://onco.cc/trials/nct04747236/), [To Evaluate Efficacy of Belinostat or Pralatrexate in Combination Against CHOP Alone in PTCL](https://onco.cc/trials/nct06072131/)
- terms: [What the NHS in England funds for lymphoma, appraisal by appraisal](https://onco.cc/terms/lymphoma-tx-uk-access/)

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