Chemotherapy-Related Skin Rashes in Mesothelioma Patients

New research is calling into question the need for an oral course of a corticosteroid that is often given to mesothelioma patients before chemotherapy with Alimta (pemetrexed).

Dexamethasone pills are supposed to help keep mesothelioma and lung cancer patients on Alimta from developing skin rashes.

But a new article in the Journal of Oncology Pharmacy Practice suggests that the pills may not be needed if patients are already getting the drug by infusion.

Alimta (Pemetrexed) and Mesothelioma Treatment

Alimta is an antifolate approved by the FDA for treating some kinds of advanced lung cancer and malignant pleural mesothelioma, also known as asbestos cancer.

Helping mesothelioma patients tolerate Alimta is important. Mesothelioma claims the lives of more than 2,500 Americans each year and is notoriously resistant to most standard cancer therapies.

While newer treatments such as immunotherapy have shown promise against this cancer, pemetrexed remains the one-and-only drug specifically approved for mesothelioma treatment. Chemotherapy with Alimta is now the standard first-line therapy for mesothelioma.

But Alimta also carries the risk of serious side effects, including renal toxicity, suppression of bone marrow function, blood clots, rash and skin peeling. Patients are given B12 to help counter some of the side effects and the drug maker also recommends oral dexamethasone.

Preventing Rash and Peeling After Chemotherapy

Researchers at the University of New Mexico Comprehensive Cancer Center compared the records of malignant mesothelioma and lung cancer patients who had been treated with at least one dose of Alimta between 2012 and 2017.

All patient received intravenous dexamethasone prior to chemotherapy. Twenty-nine patients did not receive the recommended three days of twice daily oral dexamethasone and 56 patients did (34.1% vs. 65.9%).

“There was no statistically significant difference in the incidence of cutaneous reactions between the intervention group and the control group…in patients who received intravenous dexamethasone before pemetrexed infusion,” states the report.

Chemotherapy Preparation for Mesothelioma Patients

Whether or not your doctor recommends oral dexamethasone, there are other things mesothelioma patients and families can do to help prepare for chemotherapy.

Experts at Mayo Clinic suggest that patients stock up on healthy foods like fruits and vegetables and high protein snacks like yogurt beforehand. Patients should see a dentist to ensure that there are no infections which could spread if the body’s immune system is weakened.

A light meal and a good night’s rest are also recommended on treatment days. For more tips on how to eat, supplement, and live to survive cancers like mesothelioma, request a free copy of Surviving Mesothelioma and Other Cancers by the world’s longest living mesothelioma survivor, Paul Kraus.


Clark, SK and Anselmo, LM, “Incidence of cutaneous reactions with pemetrexed: Comparison of patients who received three days of oral dexamethasone twice daily to patients who did not”, October 14, 2018, Journal of Oncology Pharmacy Practice, Epub ahead of print,


Similar Posts