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Pathway Description
Levoleucovorin Action Pathway
Homo sapiens
Drug Action Pathway
Levoleucovorin is a folate analog, used to counter the adverse effects of folic acid antagonists. Commonly used in combination with chemotherapy and 5-fluorouracil to treat patients with colorectal cancer. Folic acid is necessary in order to produce purines, pyrimidines and methionine required for DNA synthesis and replication. Once transported into the mitochondria, levoleucovorin acts to inhibit serine hydroxymethyltransferase. Without this enzyme, this halts the DNA synthesis and replication process as 5,10-Methylene-THF cannot be made. 5,10 Methylene THF is an intermediate in many amino acid pathways, such as methionine synthesis. It is also used in thymidine synthesis which is a nucleoside needed for DNA replication.
References
Levoleucovorin Pathway References
Chuang VT, Suno M: Levoleucovorin as replacement for leucovorin in cancer treatment. Ann Pharmacother. 2012 Oct;46(10):1349-57. doi: 10.1345/aph.1Q677. Epub 2012 Oct 2.
Pubmed: 23032661
Zittoun J: Pharmacokinetics and in vitro studies of l-leucovorin. Comparison with the d and d,l-leucovorin. Ann Oncol. 1993;4 Suppl 2:1-5. doi: 10.1093/annonc/4.suppl_2.s1.
Pubmed: 8353099
Jardine LF, Ingram LC, Bleyer WA: Intrathecal leucovorin after intrathecal methotrexate overdose. J Pediatr Hematol Oncol. 1996 Aug;18(3):302-4. doi: 10.1097/00043426-199608000-00014.
Pubmed: 8689347
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