Pleural mesothelioma is usually caused by exposure to asbestos and starts in the membrane around the lungs. Although there is no cure for mesothelioma, a chemotherapy combination of the platinum drug cisplatin and the anti-folate pemetrexed is considered to be the gold standard drug therapy. Unfortunately, many patients cannot tolerate high doses of cisplatin because of the danger of liver damage.
But respiratory medicine specialists at Uji Tokushukai Medical Center in Japan say this problem may be tackled for some mesothelioma patients by continuing to give them pemetrexed. Dr. Takayuki Takeda and his team report the case of a 69-year-old mesothelioma patient who saw a partial tumor response but developed signed of liver toxicity after five cycles of cisplatin and pemetrexed,.
According to their report in Internal Medicine, stopping the cisplatin but keeping the patient on “pemetrexed maintenance therapy” (PMT) for 18 more cycles produced a “complete response” and stopped the tumor’s growth.
“Although the standard of care for malignant pleural mesothelioma is the combination of cisplatin and pemetrexed and PMT still remains experimental, the adoption of PMT following cisplatin-based induction chemotherapy appears very promising and further investigation is urgently needed,” the researchers conclude.
In 2004, Alimta became the first drug approved by the FDA specifically to treat malignant pleural mesothelioma, a rare but deadly cancer that claims the lives of more than 2,500 Americans each year. Currently, mesothelioma patients who fail to see a response with cisplatin/pemetrexed chemotherapy have few other options, since no second-line drug therapy has been established.
Takeda, T et al, “Long Progression-free Survival by Pemetrexed Continuation Maintenance Therapy Following Cisplatin-based Chemotherapy in Malignant Pleural Mesothelioma”, Internal Medicine, October 15, 2014, Epub ahead of print