Patients undergoing chemotherapy for mesothelioma may avoid the rash associated with the chemotherapy drug pemetrexed if they take a small amount of a corticosteroid drug for the first three days of treatment.
Doctors at Tokushima University in Japan reviewed the cases of mesothelioma patients on chemotherapy who were treated with the corticosteroid dexamethasone with good results. Their results have just been published.
Chemotherapy Rash with Pemetrexed
Most mesothelioma patients will undergo chemotherapy at some point during their mesothelioma treatment.
Pemetrexed (Alimta) is the most common drug for mesothelioma chemotherapy, but carries a number of side effects, one of which is a serious and often uncomfortable skin rash. Pemetrexed is more likely than other types of chemotherapy drugs to cause this type of rash.
Unfortunately, as the Japanese researchers note in their newly-published article, the efficacy of using corticosteroids to treat this chemotherapy rash has not been fully verified.
Treating Mesothelioma Skin Rash with Corticosteroids
To determine the value of corticosteroid drugs like dexamethasone to treat or prevent chemotherapy rash, the team evaluated the medical records of 78 patients on chemotherapy for mesothelioma.
They found that the incidence of skin rash in the 47 mesothelioma patients who received dexamethasone was much lower than that of the 31 mesothelioma patients who did not have the medicine. (19.1% vs. 38.7%)
They also found that, when it came to treating or preventing a pemetrexed-induced rash, more of the corticosteroid was not necessarily better.
Preventing Rash in Mesothelioma Patients
In an effort to determine the most effective dose of corticosteroids for chemotherapy rash in mesothelioma patients on pemetrexed, the Japanese team compared the dosages and results in the 78 study subjects.
They found that, while a 1.5 mg/day dose of dexamethasone seemed to help many mesothelioma patients, bumping the dose up to 8 mg/day did not make skin rash any less likely or less severe.
“These results suggest that ≥1.5 mg of supplementary dexamethasone on day 2 and day 3 (in addition to day 1) may be necessary for preventing pemetrexed-induced rash, but high doses of dexamethasone (e.g., 8 mg/d) are unnecessary,” states the report.
Although it is not a cure for mesothelioma, chemotherapy with Alimta can often help relieve symptoms, reduce tumor size, improve quality of life and/or extend mesothelioma survival.
Sakurada, T et al, “Pemetrexed-Induced Rash May Be Prevented by Supplementary Corticosteroids”, 2015, Biological and Pharmacological Bulletin, pp. 1752-1756.