anthonyyazdaniml/CT-ADE-SOC huggingface dataset:
Intervention: BQ-123
Trial phase: Phase 2
SMILES: CC(C)C[C@@H]1NC(=O)[C@@H](C(C)C)NC(=O)[C@@H]2CCCN2C(=O)[C@@H](CC(=O)O)NC(=O)[C@@H](Cc2c[nH]c3ccccc23)NC1=O
Sex: All
Age groups: Adult | Older Adult
Healthy volunteers: No
Participants at risk: 23
Group description: BQ-123 will be infused at 300 nmol/min for 20 minutes prior to percutaneous coronary intervention (PCI).
Eligibility criteria:
Inclusion Criteria:

Age ≥ 18 years
Clinical diagnosis of unstable angina or non ST-elevation myocardial infarction, and requiring clinically indicated PCI for the management of non ST elevation acute coronary syndrome.

Exclusion Criteria:

Systemic hypotension (systolic <90 mmHg)
Heart failure or known ejection fraction < 30%
Left main disease
Culprit lesion is in a saphenous vein graft
100% occlusion of the culprit vessel or culprit is an ostial right coronary stenosis
Currently enrolled in other active cardiovascular investigational studies
Severe endocrine, hepatic, or renal disorders
Pregnancy or lactation
Federal Medical Center inmates
Inability or unwillingness to provide informed consent
Intervention: Chirhostim
Trial phase: Phase 1 | Phase 2
SMILES: CC(C)CC(NC(=O)CNC(=O)C(CCC(N)=O)NC(=O)C(CC(C)C)NC(=O)C(CC(C)C)NC(=O)C(CCCNC(=N)N)NC(=O)C(CCC(N)=O)NC(=O)C(CC(C)C)NC(=O)C(CCCNC(=N)N)NC(=O)C(C)NC(=O)CNC(=O)C(CCC(=O)O)NC(=O)C(CCCNC(=N)N)NC(=O)C(CC(C)C)NC(=O)C(CCCNC(=N)N)NC(=O)C(CO)NC(=O)C(CC(C)C)NC(=O)C(CCC(=O)O)NC(=O)C(CO)NC(=O)C(NC(=O)C(Cc1ccccc1)NC(=O)C(NC(=O)CNC(=O)C(CC(=O)O)NC(=O)C(CO)NC(=O)C(N)Cc1c[nH]cn1)C(C)O)C(C)O)C(=O)NC(C(N)=O)C(C)C
Sex: All
Age groups: Adult | Older Adult
Healthy volunteers: No
Participants at risk: 4
Group description: 10 adults, diagnosed diabetes within two years, and at least one of the following: no family history of diabetes, abdominal discomfort, anorexia, weight loss, elevated serum cancer antigen 19-9 (CA 19-9), or those undergoing endoscopic ultrasound (EUS) with or without Fine Needle Aspiration (FNA) for pancreatic cancer screening.

All subjects on this arm will receive Synthetic Human Secretin as a 0.2mcg/kg one time dose prior to CT imaging on Day 1 of the study.
Eligibility criteria:
Inclusion Criteria:

Persons 50 years or older with recently diagnosed diabetes (within 2 years), with at least one of the following: no family history of diabetes, abdominal discomfort, anorexia, weight loss, elevated serum CA 19-9, or those undergoing EUS with or without Fine Needle Aspiration (FNA) for pancreatic cancer screening ; OR
Persons 35 years old or older with familial pancreatic cancer with 2 or more first degree relatives with pancreatic cancer; OR
Persons 35 years old or older with Peutz-Jeghers syndrome; OR
Persons 35 years old or older with suspicious clinical symptoms of pancreatic cancer, but had normal CT of the abdomen with iodinated contrast within 2 weeks.

Exclusion Criteria:

Persons with contraindication to iodinated contrast
Allergy to iodinated contrast
Renal insufficiency (serum creatinine > 1.5 mg/dl)
Patients with contraindication to ionizing radiation
Pregnancy
Patients with previous pancreatic surgery
Contraindication to secretin
Allergy to secretin
Acute pancreatitis
Intervention: Chirhostim
Trial phase: Phase 1 | Phase 2
SMILES: CC(C)CC(NC(=O)CNC(=O)C(CCC(N)=O)NC(=O)C(CC(C)C)NC(=O)C(CC(C)C)NC(=O)C(CCCNC(=N)N)NC(=O)C(CCC(N)=O)NC(=O)C(CC(C)C)NC(=O)C(CCCNC(=N)N)NC(=O)C(C)NC(=O)CNC(=O)C(CCC(=O)O)NC(=O)C(CCCNC(=N)N)NC(=O)C(CC(C)C)NC(=O)C(CCCNC(=N)N)NC(=O)C(CO)NC(=O)C(CC(C)C)NC(=O)C(CCC(=O)O)NC(=O)C(CO)NC(=O)C(NC(=O)C(Cc1ccccc1)NC(=O)C(NC(=O)CNC(=O)C(CC(=O)O)NC(=O)C(CO)NC(=O)C(N)Cc1c[nH]cn1)C(C)O)C(C)O)C(=O)NC(C(N)=O)C(C)C
Sex: All
Age groups: Adult | Older Adult
Healthy volunteers: No
Participants at risk: 4
Group description: 10 adults age 35-99 with familial pancreatic cancer with two or more first degree relatives with pancreatic cancer

All subjects on this arm will receive Synthetic Human Secretin as a 0.2mcg/kg one time dose prior to CT imaging on Day 1 of the study.
Eligibility criteria:
Inclusion Criteria:

Persons 50 years or older with recently diagnosed diabetes (within 2 years), with at least one of the following: no family history of diabetes, abdominal discomfort, anorexia, weight loss, elevated serum CA 19-9, or those undergoing EUS with or without Fine Needle Aspiration (FNA) for pancreatic cancer screening ; OR
Persons 35 years old or older with familial pancreatic cancer with 2 or more first degree relatives with pancreatic cancer; OR
Persons 35 years old or older with Peutz-Jeghers syndrome; OR
Persons 35 years old or older with suspicious clinical symptoms of pancreatic cancer, but had normal CT of the abdomen with iodinated contrast within 2 weeks.

Exclusion Criteria:

Persons with contraindication to iodinated contrast
Allergy to iodinated contrast
Renal insufficiency (serum creatinine > 1.5 mg/dl)
Patients with contraindication to ionizing radiation
Pregnancy
Patients with previous pancreatic surgery
Contraindication to secretin
Allergy to secretin
Acute pancreatitis
Intervention: Chirhostim
Trial phase: Phase 1 | Phase 2
SMILES: CC(C)CC(NC(=O)CNC(=O)C(CCC(N)=O)NC(=O)C(CC(C)C)NC(=O)C(CC(C)C)NC(=O)C(CCCNC(=N)N)NC(=O)C(CCC(N)=O)NC(=O)C(CC(C)C)NC(=O)C(CCCNC(=N)N)NC(=O)C(C)NC(=O)CNC(=O)C(CCC(=O)O)NC(=O)C(CCCNC(=N)N)NC(=O)C(CC(C)C)NC(=O)C(CCCNC(=N)N)NC(=O)C(CO)NC(=O)C(CC(C)C)NC(=O)C(CCC(=O)O)NC(=O)C(CO)NC(=O)C(NC(=O)C(Cc1ccccc1)NC(=O)C(NC(=O)CNC(=O)C(CC(=O)O)NC(=O)C(CO)NC(=O)C(N)Cc1c[nH]cn1)C(C)O)C(C)O)C(=O)NC(C(N)=O)C(C)C
Sex: All
Age groups: Adult | Older Adult
Healthy volunteers: No
Participants at risk: 4
Group description: 10 adults age 35-99 with Peutz-Jeghers syndrome.

All subjects on this arm will receive Synthetic Human Secretin as a 0.2mcg/kg one time dose prior to CT imaging on Day 1 of the study.
Eligibility criteria:
Inclusion Criteria:

Persons 50 years or older with recently diagnosed diabetes (within 2 years), with at least one of the following: no family history of diabetes, abdominal discomfort, anorexia, weight loss, elevated serum CA 19-9, or those undergoing EUS with or without Fine Needle Aspiration (FNA) for pancreatic cancer screening ; OR
Persons 35 years old or older with familial pancreatic cancer with 2 or more first degree relatives with pancreatic cancer; OR
Persons 35 years old or older with Peutz-Jeghers syndrome; OR
Persons 35 years old or older with suspicious clinical symptoms of pancreatic cancer, but had normal CT of the abdomen with iodinated contrast within 2 weeks.

Exclusion Criteria:

Persons with contraindication to iodinated contrast
Allergy to iodinated contrast
Renal insufficiency (serum creatinine > 1.5 mg/dl)
Patients with contraindication to ionizing radiation
Pregnancy
Patients with previous pancreatic surgery
Contraindication to secretin
Allergy to secretin
Acute pancreatitis
Intervention: Chirhostim
Trial phase: Phase 1 | Phase 2
SMILES: CC(C)CC(NC(=O)CNC(=O)C(CCC(N)=O)NC(=O)C(CC(C)C)NC(=O)C(CC(C)C)NC(=O)C(CCCNC(=N)N)NC(=O)C(CCC(N)=O)NC(=O)C(CC(C)C)NC(=O)C(CCCNC(=N)N)NC(=O)C(C)NC(=O)CNC(=O)C(CCC(=O)O)NC(=O)C(CCCNC(=N)N)NC(=O)C(CC(C)C)NC(=O)C(CCCNC(=N)N)NC(=O)C(CO)NC(=O)C(CC(C)C)NC(=O)C(CCC(=O)O)NC(=O)C(CO)NC(=O)C(NC(=O)C(Cc1ccccc1)NC(=O)C(NC(=O)CNC(=O)C(CC(=O)O)NC(=O)C(CO)NC(=O)C(N)Cc1c[nH]cn1)C(C)O)C(C)O)C(=O)NC(C(N)=O)C(C)C
Sex: All
Age groups: Adult | Older Adult
Healthy volunteers: No
Participants at risk: 4
Group description: 10 adults age 35-99 with suspicious clinical symptoms of pancreatic cancer, but had normal CT of the abdomen with iodinated contrast within 2 weeks.
Eligibility criteria:
Inclusion Criteria:

Persons 50 years or older with recently diagnosed diabetes (within 2 years), with at least one of the following: no family history of diabetes, abdominal discomfort, anorexia, weight loss, elevated serum CA 19-9, or those undergoing EUS with or without Fine Needle Aspiration (FNA) for pancreatic cancer screening ; OR
Persons 35 years old or older with familial pancreatic cancer with 2 or more first degree relatives with pancreatic cancer; OR
Persons 35 years old or older with Peutz-Jeghers syndrome; OR
Persons 35 years old or older with suspicious clinical symptoms of pancreatic cancer, but had normal CT of the abdomen with iodinated contrast within 2 weeks.

Exclusion Criteria:

Persons with contraindication to iodinated contrast
Allergy to iodinated contrast
Renal insufficiency (serum creatinine > 1.5 mg/dl)
Patients with contraindication to ionizing radiation
Pregnancy
Patients with previous pancreatic surgery
Contraindication to secretin
Allergy to secretin
Acute pancreatitis
Intervention: Lidocaine
Trial phase: Not Applicable
ATC code: C01BB01 | C05AD01 | D04AB01 | N01BB02 | N01BB52 | R02AD02 | S01HA07 | S02DA01
SMILES: CCN(CC)CC(=O)Nc1c(C)cccc1C
Sex: All
Age groups: Adult | Older Adult
Healthy volunteers: No
Participants at risk: 342
Group description: Subjects randomized to receive Lidocaine 1.5 mg/kg via the cardiopulmonary reservoir prior to the removal of the aortic cross clamp.
Eligibility criteria:
Inclusion Criteria:

Patients undergoing cardiac surgery that was expected to include cross-clamping of the aorta

Exclusion Criteria:

Women wishing to become pregnant within 6 months of surgery
Allergy to amiodarone
History of organ dysfunction due to previous amiodarone use
Patients who require more than mild systemic hypothermia (<32 degrees C) during cardiopulmonary bypass
Patients who require more than one bypass run or more than one period of aortic cross-clamping
Intervention: Chlorogenic Acid
Trial phase: Phase 2
SMILES: O=C(/C=C/c1ccc(O)c(O)c1)O[C@@H]1C[C@](O)(C(=O)O)C[C@@H](O)[C@H]1O
Sex: All
Age groups: Adult | Older Adult
Healthy volunteers: No
Participants at risk: 70
Group description: St. John's Wort, 450 mg twice a day
Eligibility criteria:
Inclusion Criteria:

Established diagnosis of IBS
Meet Rome II diagnostic criteria for IBS
18-70 years of age
U.S. resident
English-speaking (able to provide consent and complete questionnaires)
Able to participate in all aspects of the study

Exclusion Criteria:

Known alternative/concurrent gastrointestinal diagnosis (e.g. Crohn's disease, ulcerative colitis, microscopic colitis, celiac sprue, chronic pancreatitis or pancreatic insufficiency, scleroderma, chronic intestinal pseudo-obstruction, bacterial overgrowth, recent (<6 months) intestinal bacterial/protozoal/ parasitic infections, HIV, fecal incontinence, small bowel or colonic resection, pelvic floor dysfunction, paraplegia or quadriplegia)
Current symptoms of severe depression, as measured by Center for Epidemiological Studies Depression Scale (CES-D) score
Mental retardation or any condition requiring a legal guardian
Current or past history of psychotic disorder (schizophrenia, bipolar disorder)

Recent or current use (within past 30 days) of select mood or pain or symptom-altering medications:

benzodiazepine use
substance abuse
narcotic use
antihistamine use
barbiturates
zaleplon (Sonata)

Recent or current use (within past 30 days) of drugs that interact with SJW:

antidepressants or antipsychotics
tramadol (Ultram)
sumatriptan (Imitrex)
digoxin (Lanoxin)
anticonvulsants (e.g. carbamazepine or phenytoin)
immunosuppressants: cyclosporine and tacrolimus
HIV protease inhibitors (e.g. indinavir), non-nucleoside reverse transcriptase inhibitors (e.g. nevirapine)
warfarin (Coumadin)
theophylline
chemotherapy
sulfa-containing drugs
piroxicam (Feldene)
simvastatin (Zocor)
sibutramine (Meridia)
verapamil (Calan or Isoptin)
Planned surgery (especially transplant) or anesthesia exposure during trial
Known photosensitivity or planned photodiagnostic or phototherapy procedures
Are pregnant, lactating, likely to become pregnant during medication phase and not willing to use a reliable form of contraception (barrier contraceptives, diaphragm, injections, intrauterine device, surgical sterilization, and abstinence)
Recent or current use (within 30 days) of SJW, other herbal products for IBS, investigational drug use
Known allergy to SJW
Significant acute or chronic progressive neurologic, hepatic, renal, cardiovascular, respiratory or metabolic disease
Recent history of alcohol or substance dependence use or abuse
Another household member or relative participating in the study
Professional drivers or operators of heavy machinery
Major cardiovascular events in the last 6 months
Use of IBS-specific drugs such as tegaserod (Zelnorm) and Lotronex (Alosetron) (within 30 days)
Intervention: Gabapentin
Trial phase: Not Applicable
ATC code: N02BF01 | N03AX12
SMILES: NCC1(CC(=O)O)CCCCC1
Sex: All
Age groups: Adult | Older Adult
Healthy volunteers: Accepts Healthy Volunteers
Participants at risk: 57
Group description: Preoperative gabapentin 600 mg p.o. within 2 hours prior to surgery.
Eligibility criteria:
Inclusion criteria:

Age 45-75 years
Undergoing thoracotomy (lobectomy, segmentectomy, wedge resection)

Exclusion criteria:

Undergoing chest wall resection, gastroesophageal surgery
Enrolled in another post-thoracotomy analgesic research protocol
Pre-existing pain syndrome
Current gabapentin or pregabalin therapy
Inability to understand the study protocol
Coagulopathy
Current use of anticoagulants
Allergy to medications on protocol
Creatinine >1.3
Moderate or severe aortic stenosis
Severe psychological disorders
Bacteremia, osteomyelitis, or infection at site of thoracic epidural placement
History of previous thoracotomy
Patient declines preoperative epidural catheter placement
Prisoners or other institutionalized individuals
Severe hepatic, renal or cardiovascular disorders
Women who can become pregnant
Intervention: Temozolomide
Trial phase: Phase 2
ATC code: L01AX03
SMILES: Cn1nnc2c(C(N)=O)ncn2c1=O
Sex: All
Age groups: Adult | Older Adult
Healthy volunteers: No
Participants at risk: 24
Group description: Temozolomide: Patients will then be treated with TMZ according to the extended dosing schedule of 75mg/m2/day x 6 weeks every 8 weeks.
Eligibility criteria:
Inclusion Criteria:

Palpable Stage III (N1b, N2b, N2c, or N3) or Stage IV (M1a) cutaneous melanoma. Patient must be a potential candidate for complete surgical resection.
Age ≥ 18 years
Histologic proof of pathology reviewed and confirmed at MSKCC
Measurable disease by RECIST criteria
Determination of surgical resectability by surgeon at MSKCC
No prior chemotherapy for melanoma. Prior interferon, interleukin-2 or vaccine therapy is allowed.
No other concurrent chemotherapy, immunotherapy, or radiotherapy
Karnofsky performance status ≥60
Adequate organ function

Exclusion Criteria:

Uveal or mucosal melanoma
Patients with melanoma deemed not amenable to surgical resection or who are not surgical candidates for medical reasons
Frequent vomiting or medical conditions that could interfere with oral medication intake
Serious infection requiring antibiotics, or nonmalignant medical illnesses that are uncontrolled or whose control might be jeopardized by the complications of this therapy
Pregnancy or nursing
History of HIV infection even if on HAART as TMZ leads to CD4+ T cell leukopenia
Concurrent use of high dose vitamins and herbs
Other on-going investigational therapy, concurrent chemotherapy, immunotherapy or radiotherapy
Intervention: Victoza
Trial phase: Not Applicable
ATC code: A10BJ02
SMILES: CCCCCCCCCCCCCCCC(=O)NC(CCC(=O)NCCCCC(NC(=O)C(C)NC(=O)C(C)NC(=O)C(CCC(N)=O)NC(=O)CNC(=O)C(CCC(=O)O)NC(=O)C(CC(C)C)NC(=O)C(Cc1ccc(O)cc1)NC(=O)C(CO)NC(=O)C(CO)NC(=O)C(NC(=O)C(CC(=O)O)NC(=O)C(CO)NC(=O)C(NC(=O)C(Cc1ccccc1)NC(=O)C(NC(=O)CNC(=O)C(CCC(=O)O)NC(=O)C(C)NC(=O)C(N)Cc1cnc[nH]1)C(C)O)C(C)O)C(C)C)C(=O)NC(CCC(=O)O)C(=O)NC(Cc1ccccc1)C(=O)NC(C(=O)NC(C)C(=O)NC(Cc1c[nH]c2ccccc12)C(=O)NC(CC(C)C)C(=O)NC(C(=O)NC(CCCNC(=N)N)C(=O)NCC(=O)NC(CCCNC(=N)N)C(=O)NCC(=O)O)C(C)C)C(C)CC)C(=O)O
Sex: All
Age groups: Adult
Healthy volunteers: Accepts Healthy Volunteers
Participants at risk: 88
Group description: All participants recieved glucose for 2 hours then Glucagon Like Peptide-1 (GLP-1) intravenously at a rate of 0.75 pmol/kg/min for 1 hour followed by 1.5 pmol/kg/min for the subsequent hour. The study lasted for 240 minutes.
Eligibility criteria:
Inclusion Criteria:

Aged 18-40
fasting glucose concentration of less than 95 mg/dl.

Exclusion Criteria:

Individuals with a BMI < 19 or > 40 kg/m^2
active systemic illness
medication that can alter gastric emptying, insulin secretion & action
history of abdominal surgery (other than appendectomy or tubal ligation).
Intervention: Gefitinib
Trial phase: Phase 2
ATC code: L01EB01 | L01XE02
SMILES: COc1cc2ncnc(Nc3ccc(F)c(Cl)c3)c2cc1OCCCN1CCOCC1
Sex: All
Age groups: Adult | Older Adult
Healthy volunteers: No
Participants at risk: 65
Group description: Gefitinib: Patients will receive gefitinib 250 mg po daily for at least 21 days preoperatively (depending on the timing of the surgery). Treatment with gefitinib will be stopped 2 days before the date of surgery.

Patients who have had at least a minor response to gefitinib therapy preoperatively (> 25% reduction in tumor measured bidimensionally) and / or have mutations in the protein-tyrosine kinase domain of the EGF receptor gene identified will continue on the study and will resume gefitinib treatment after at least 7 days from surgery providing adequate wound healing has occurred.

Patients who are determined to be candidates for adjuvant chemotherapy and/or radiation therapy by their treating physician may receive treatment with adjuvant chemotherapy and/or radiation therapy. The post-operative gefitinib will be started after completion of the chemotherapy and/or radiation therapy.
Eligibility criteria:
Inclusion Criteria:

Pathologic confirmation of malignancy at Memorial Sloan-Kettering
Patients must have previously untreated stage I or II NSCLC (T11-2N0M0, T1-2N1M0, T3N0M0) and 1 of the following features: never smoker or < 15 pack year smoking history and/or bronchioloalveolar cancer (either pure BAC, BAC with focal invasion or adenocarcinoma with BAC features)
Patients must have been determined to be operable and resectable by the treating thoracic surgeon.
Age >18 years.
Measurable indicator lesions
Ability to understand and the willingness to sign a written informed consent document.

Exclusion Criteria:

Pregnant or lactating women or women of childbearing potential not using effective contraception. Men participating in the trial must also use effective contraception when sexually active.
Patients may not be receiving any other investigational agents.
Any history of or evidence of interstitial lung disease (patients with chronic stable radiographic changes who are asymptomatic need not be excluded).
Intervention: Simvastatin
Trial phase: Not Applicable
ATC code: A10BH51 | C10AA01 | C10BA02 | C10BA04 | C10BX01 | C10BX04
SMILES: CCC(C)(C)C(=O)OC1CC(C)C=C2C=CC(C)C(CCC3CC(O)CC(=O)O3)C21
Sex: All
Age groups: Adult | Older Adult
Healthy volunteers: No
Participants at risk: 28
Group description: Subjects randomized to this arm will be pretreated with 80 mg (2 pills) simvastatin approximately one hour prior to percutaneous coronary intervention.
Eligibility criteria:
Inclusion Criteria:

Patients undergoing PCI/angiography
No previously known side effects of statins
Patients who sign an informed consent
Age > 18 years old

Exclusion Criteria:

Patients with ST elevation myocardial infarction
Patients with cardiogenic shock
Patients with hypersensitivity to statins
Patients with unexplained muscle pain
Patients with acute liver disease
Patients receiving cyclosporine, antifungal azoles, macrolide antibiotics, niacin, fibrates> 1 quart grapefruit juice/day or nefazodone
Patients with creatinine > 2.0
Patients with known malignancy
Ejection Fraction < 25%
No coronary care unit patients
No outpatients
Intervention: Cannabidiol
Trial phase: Phase 2
ATC code: N03AX24
SMILES: C=C(C)[C@@H]1CCC(C)=C[C@H]1c1c(O)cc(CCCCC)cc1O
Sex: All
Age groups: Adult | Older Adult
Healthy volunteers: No
Participants at risk: 21
Group description: Cannabidiol: Active Cannabidiol daily over 6 weeks
Eligibility criteria:
Inclusion Criteria:

Schizophrenia or Schizoaffective disorder (DSM-IV SCID-confirmed),

Exclusion Criteria:

Women who are pregnant, nursing or unwilling to use appropriate birth control measures during study participation.
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: 25
Group description: Patients will receive pemetrexed (500 mg/m2 IV infusion over approximately 10 minutes) followed immediately by gemcitabine (1250 mg/m2 IV infusion given over approximately 30 minutes) on day 1 and day 15 of a 28-day cycle.
Eligibility criteria:
Inclusion Criteria:

Patients must have microscopically confirmed epidermoid/squamous cell carcinoma (HNSCC) of the oral cavity, pharynx, larynx, paranasal sinus, or head/neck squamous cell carcinoma unknown primary.
Patients must have recurrent or metastatic disease which is not amenable to curative-intent therapy with surgery or radiation.
No more than 2 prior cytotoxic therapies in the recurrent or metastatic disease setting are permitted.
Patients must be at least 18 years of age.
Karnofsky Performance status must be ≥ 70%.
Disease must be measurable by RECIST criteria.
At least 4 weeks must have elapsed from previous radiation therapy. Patient must have recovered from the acute toxic effects of treatment prior to study enrollment.
Prior radiation therapy to ≤ 25% of bone marrow is allowed. Prior radiation to the whole pelvis and/or brain is not allowed.
Adequate organ function
Patients of childbearing potential must have a negative test for pregnancy at time of enrollment based on a urine or serum pregnancy test. Patients must agree to use a reliable method of birth control during and for 3 months following the last dose of study drug.
Patient must reside in geographic proximity to MSKCC for adequate follow-up during treatment, per investigator discretion.
Patients must sign an informed consent document.

Exclusion Criteria:

Previous exposure to pemetrexed (Alimta) or gemcitabine (Gemzar).
Pregnancy or breast-feeding.
Serious concomitant systemic disorders (for example, active infection) that, in the opinion of the investigator, would compromise the safety of the patient or compromise the patient's ability to complete the study.
History of any brain metastases.
Inability or unwillingness to take folic acid, vitamin B12 supplementation, or dexamethasone.
Patients will be excluded if they will be unable to hold use of nonsteroidal antiinflammatory agents (NSAIDS) with short elimination half lives