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Chemotherapy with Alimta: Putting More Gold in the Gold Standard

chemotherapy with AlimtaA new Italian study suggests there may be a more effective way to deliver mesothelioma chemotherapy with Alimta.

Chemotherapy with Alimta (pemetrexed) is the gold standard treatment for malignant pleural mesothelioma. But fewer than 40 percent of mesothelioma patients see improvement when they receive the drug by standard infusion.

Now, researchers in biotechnology and nanomedicine think they may have found a way around the limits of chemotherapy with Alimta. Tiny particles of gold may be the answer.

Why Chemotherapy with Alimta Does Not Always Work

Even though most mesothelioma patients receive chemotherapy with Alimta at some point, it is usually only moderately effective.

That is because pemetrexed is a highly potent drug that can cause deadly side effects at high doses. To protect patients and make the treatment tolerable, doctors have to limit the dose of systemic chemotherapy with Alimta.

A limited dose means the medicine is less likely to kill all of the mesothelioma cells. Eventually, most mesothelioma tumors are able to take hold again after this treatment.

A New Delivery Method for Mesothelioma Chemotherapy

The Italian researchers were looking for a way around the problem of toxicity in chemotherapy with Alimta. They found it in gold nanoparticles (GNPs).

The first challenge was to help the GNPs find and enter mesothelioma cells. The GNPs got a coating to attract them to mesothelioma cells expressing the protein CD146.

A fluorescent tracking dye on the GNPs proved that mesothelioma cells took the bait.

Next, mesothelioma cells were treated with GNPs that had been loaded with pemetrexed.

“Both cell viability and motility were significantly affected by nanoparticle treatment compared to pemetrexed,” writes lead author Emanuela Cova with the San Matteo Foundation in Pavia.

The researchers say pemetrexed-loaded GNPs could even be delivered directly into the pleural space where mesothelioma tumors grow.

“The innovative use of specifically targeted GNPs opens the prospect of local intrapleural administration to avoid normal cell toxicity and enhance chemotherapy efficacy,” writes Dr. Cova.

Delivering chemotherapy with Alimta in this way would help keep the drug from effecting normal tissue, allowing doctors to give a higher, more powerful dose.

About Chemotherapy with Alimta

To date, Alimta is the only drug specifically approved by the FDA for the treatment of mesothelioma. It is usually administered via infusion in combination with a platinum-based drug like cisplatin or carboplatin.

Alimta is an anti-folate, which has the potential to deplete Vitamin B stores in the body. Patients who get chemotherapy with Alimta are often prescribed folic acid and vitamin B12 supplements to help reduce side effects.

Patients usually also get corticosteroids to reduce the risk of skin rashes.


Cova, E, et al, “Pemetrexed-loaded nanoparticles targeted to malignant pleural mesothelioma cells: an in vitro study”, January 23, 2019, https://www.dovepress.com/pemetrexed-loaded-nanoparticles-targeted-to-malignant-pleural-mesothel-peer-reviewed-article-IJN

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