Intervention: Pemetrexed
Trial phase: Phase 2
ATC code: L01BA04
SMILES: Nc1nc(=O)c2c(CCc3ccc(C(=O)N[C@@H](CCC(=O)O)C(=O)O)cc3)c[nH]c2[nH]1
Sex: All
Age groups: Adult | Older Adult
Healthy volunteers: No
Participants at risk: 6
Group description: Pemetrexed 500 mg/m2 will be administered on an outpatient basis on an every three week schedule. Pemetrexed will be administered as a 10 minutes intravenous (IV) infusion in (for 500-mg vial) 100 ml of saline via peripheral vein or central line on Day 1 of each 21 day cycle.

Pemetrexed: Pemetrexed 500 mg/m2
Eligibility criteria:
Inclusion Criteria:

Patients must have had advanced or recurrent adenocarcinoma or adenosquamous cell carcinoma of the cervix with documented disease progression
Patients must have had measurable disease defined as at least one lesion that could be accurately measured in at least one dimension, which must have been 20 mm when measured by conventional techniques including palpation, plain X-ray, computerized tomography (CT), and magnetic resonance imaging(MRI) or 10 mm when measured by spiral CT
18 years of age or older
Eastern Cooperative Oncology Group (ECOG) performance status score < 2 and a life expectancy >3 months
Life expectancy ≥ 12 weeks
Participants must have measureable disease by RECIST criteria
Absolute neutrophil count > 1500 mm3, platelet count ≥ 100×109 L, hemoglobin ≥ 8.5 g/dL

Creatinine clearance ≥ 45 mL/min using the standard Cockcroft and Gault formula (below) or glomerular filtration rate (GFR) measured by Tc99m-diethylenetriaminepentacetate (DPTA) serum clearance method:

Males: [140 - Age in years] × Actual Body Weight (kg) 72 × Serum Creatinine (mg/dL)
Females: Estimated creatinine clearance for males × 0.85
Total bilirubin ≤ 2 mg/dL, aspartate transaminase (AST) and alanine transaminase (ALT) AST/ALT ≤ 5 times the upper limit of normal range
At least 21 days from administration of chemotherapy
No remaining grade 2 or higher toxicity from prior cancer therapies unless judged to be clinically insignificant by the Principal Investigator
At least four (4) weeks from prior major surgery
Willingness to provide permission to access archived tumor samples and additional blood samples for evaluation of Foundation One Analysis where available Enterprise wide.
Women of child-bearing potential (i.e., women who are pre-menopausal or not surgically sterile) must be willing to use an acceptable contraceptive method (abstinence, oral contraceptive or double barrier method) for the duration of the study and for 30 days following the last dose of study drug, and must have a negative urine or serum pregnancy test within 2 weeks prior to beginning treatment on this trial.

Exclusion Criteria:

Uncontrolled cardiac disease, congestive heart failure, angina, arrhythmias or hypertension.
Myocardial infarction or unstable angina within 2 months of treatment.
Known human immunodeficiency virus (HIV) infection or chronic active Hepatitis B or C (patients are NOT required to be tested for the presence of such viruses prior to therapy on this protocol).
Active clinically serious infection > CTCAE (version 4.03) Grade 2.
Thrombotic or embolic events such as a cerebrovascular accident including transient ischemic attacks within the past 6 months.
Pulmonary hemorrhage/bleeding event ≥ CTCAE Grade 2 within 4 weeks of first dose of study drug.
Any other hemorrhage/bleeding event ≥ CTCAE Grade 3 within 4 weeks of first dose of study drug.
Serious non-healing wound, ulcer, or bone fracture.
Major surgery, open biopsy or significant traumatic injury within 4 weeks of first study drug.
Inability to complete informed consent process and adhere to the protocol treatment plan and follow-up requirements.
Concurrent severe illness such as active infection, or psychiatric illness/social situations that would limit safety and compliance with study requirements.