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Leucovorin (LV) may abrogate pralatrexate (PDX) activity through three mechanisms. i Competition for reduced folate carrier type 1 (RFC) transport into cell. ii Competition for polyglutamylation, a retention and activity marker, by folylpolyglutamate synthase (FPGS). iii Provides an alternate source of tetrahydrofolate, working around PDX inhibition of dihydrofolate reductase (DHFR)
