Chemotherapy – H. Lee Moffitt Cancer Center and Research Institute
By 2008, it was pretty clear that the chemotherapy combination of Alimta (also called Pemetrexed) and Cisplatin (or Carboplatin) was an effective therapy for some patients with mesothelioma. In this study the researchers wanted to know if another combination of chemo would be better or worse. They decided to test Pemetrexed and gemcitabine because in animal tests this combination showed that it might be effective.
The two drugs were given for six cycles or until the mesothelioma got worse. In addition to the two chemo drugs, patients were also given folic acid, vitamin B(12), and dexamethasone. They tried this clinical trial in 20 patients from December 2002 to May 2004 and the H. Lee Moffitt Cancer Center and Research Institute in Florida. One patient died from the treatment. The median survival was reported as 26.8 months. The researchers concluded that the treatment “seems promising.”
Today, this treatment appears not to be used widely. However, it may be used when a patient cannot tolerate cisplatin or carboplatin.
Patients: This phase II study involved 20 patients with pleural mesothelioma. The majority (75%) were male. Their median age was 67.5, ranging from 46 to 79 years of age.
Treatment: Patients were treated with the chemotherapy drugs pemetrexed and gemcitabine.
Toxicity: One patient died from multiple organ failure related to treatment with the study drugs. The most frequently reported grade 3 and 4 toxicities were neutropenia (occurring in 60% of patients), febrile neutropenia (reported in 10% of patients), and anemia (reported in 1 patient). Other grade 3 and 4 toxicities were fatigue, dehydration, constipation, vomiting, diarrhea, dyspnea, and nausea.
Results: The median overall survival was 26.8 months.
Support: This study was supported by research funds from Eli Lilly & Co., which markets gemcitabine as Gemzar and pemetrexed as Alimta.
Correspondence: Dr. George R. Simon