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Its anticancer effects occur through several sophisticated mechanisms: Multi-Enzyme Inhibition : Pemetrexed and its polyglutamated metabolites inhibit multiple folate-dependent enzymes critical for cell division: Thymidylate synthase (TS) Dihydrofolate reductase (DHFR) Glycinamide ribonucleotide formyltransferase (GARFT) Aminoimidazole carboxamide ribonucleotide formyltransferase (AICARFT) Disruption of DNA Synthesis : By inhibiting these enzymes, pemetrexed prevents the formation of thymidine and purine nucleotides essential for DNA synthesis and repair
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