A new study suggests that the lower cost chemotherapy drug Gemzar (gemcitabine) combined with a platinum based agent (cisplatin or carboplatin) may be just as effective at treating advanced pleural mesothelioma as the gold standard mesothelioma drug Alimta (pemetrexed) .
Doctors in Turkey, a country with one of the world’s highest rates of mesothelioma, tracked 116 mesothelioma patients who were treated with a combination of Alimta and a platinum drug between 1999 and 2012. During the same period, 30 mesothelioma patients received the alternative combination of Gemzar and a platinum drug.
There were no differences between the two groups in terms of age, gender, asbestos exposure, histological subtype, cancer stage or other characteristics. The mean age of the patients was just under 61 years old and most had the epithelioid type of mesothelioma.
The team found no significant differences in the mesothelioma survival rates of these two groups. According to corresponding study author Guntulu Ak of Eskisehir Osmangazi University in Eskisehir, Turkey, “After adjusting for the stage and Karnofsky performance status [overall physical health], the chemotherapy schema was not impressive on median survival time.”
In other words, regardless of which chemotherapy regimen was used, most patients experienced similar results. In most cases, mesothelioma began to grow again in 6 or 7 months after treatment and most patients died of the disease in about a year after diagnosis. The researchers conclude that, although not necessarily better, Gemzar is an effective and safe alternative to Alimta for treating mesothelioma.
A 2014 Mexican study of Gemzar in advanced mesothelioma patients produced more encouraging results. That study found that Gemzar was not only less expensive than Alimta but also produced fewer serious side effects and improved survival slightly. If the results of the current study can be confirmed in larger, randomized phase III trials, it could change the way some mesothelioma patients are treated.
Ak, G et al, “The effectiveness and safety of platinum-based pemetrexed and platinum-based gemcitabine treatment in patients with malignant pleural mesothelioma”, July 9, 2015, BMC Cancer, Epub head of print