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The Common Terminology Criteria for Adverse Events (CTCAE), [1] formerly called the Common Toxicity Criteria (CTC or NCI-CTC), are a set of criteria for the standardized classification of adverse events of drugs and treatment used in cancer therapy. The CTCAE system is a product of the US National Cancer Institute (NCI).
Folate targeting is a method utilized in biotechnology for drug delivery purposes. This Trojan Horse process, which was created by Drs. Christopher P. Leamon and Philip S. Low, involves the attachment of the vitamin, folate (), to a molecule/drug to form a "folate conjugate". [1]
Both high-folate diets and supplemental folic acid may help reduce the toxic side-effects of low-dose methotrexate without decreasing its effectiveness. [ 8 ] [ 9 ] Anyone taking low-dose methotrexate for the health problems listed above should consult with a physician about the need for a folic acid supplement.
Patients are recommended to take folic acid and vitamin B 12 supplement even if levels are normal when they are on pemetrexed therapy. [15] [2] (In clinical trials for mesothelioma, folic acid and B12 supplementation reduced the frequency of adverse events.)
Folinic acid, also known as leucovorin, is a medication used to decrease the toxic effects of methotrexate and pyrimethamine. [2] [3] It is also used in combination with 5-fluorouracil to treat colorectal cancer and pancreatic cancer, may be used to treat folate deficiency that results in anemia, and methanol poisoning.
The 2013–2014 survey reported that for adults ages 20 years and older, men consumed an average of 249 μg/day folate from food plus 207 μg/day of folic acid from consumption of fortified foods, for a combined total of 601 μg/day of dietary folate equivalents (DFEs because each microgram of folic acid counts as 1.7 μg of food folate).
Levomefolic acid (and folic acid in turn) has been proposed for treatment of cardiovascular disease [10] [11] and advanced cancers such as breast and colorectal cancers. [12] It bypasses several metabolic steps in the body and better binds thymidylate synthase with FdUMP, a metabolite of the drug fluorouracil.
For example, methotrexate is used as cancer chemotherapy because it can prevent neoplastic cells from dividing. [1] [2] Bacteria also need DHFR to grow and multiply and hence inhibitors selective for bacterial vs. host DHFR have found application as antibacterial agents. [3] Tetrahydrofolate synthesis pathway