Chemotherapy

What is Chemotherapy?

Chemotherapy is a group of toxic drugs that kill cells (mesothelioma, other cancers, and healthy cells) by damaging their DNA. Chemotherapy is a cytotoxic therapy, meaning it kills cells. Chemo drugs target rapidly growing cancer cells, but they can also affect healthy cells that grow rapidly such as blood cells. The effect of these drugs on both cancer and normal cells often causes chemo side effects.

Alimta (Pemetrexed) and Cisplatin

As of this writing, the only FDA approved chemotherapy for mesothelioma is a combination of Alimta (pemetrexed) and cisplatin. In February 2004, the Food and Drug Administration approved pemetrexed for the treatment of malignant pleural mesothelioma in combination with cisplatin for patients whose disease is either inoperable or who are not otherwise candidates for curative surgery. Patients who take this chemo regimen are often prescribed folic acid and vitamin B12 supplement to help reduce side effects from the chemotherpay. Patients are usually prescribed corticosteroids to reduce the risk of skin rashes as well.

The recommended dose of pemetrexed is 500 mg/m administered as an intravenous infusion over 10 minutes on day 1 of each 21-day cycle together with cisplatin at a dose of 75 mg/m infused over 2 hours beginning 30 minutes after the pemetrexed infusion.

The Clinical Trial that Approved Alimta (Pemetrexed) and Cisplatin

There was one key clinical trial that led to the FDA approval of this regimen for mesothelioma. Two hundred twenty-six pleural mesothelioma patients were randomized to receive pemetrexed and cisplatin, while 222 patients were randomized to receive cisplatin alone. The primary study end point was survival. Median survival times were 12.1 months for the pemetrexed plus cisplatin treatment group and 9.3 months for the cisplatin alone group.

Median time to progression (regrowth of tumor) was longer in the pemetrexed/cisplatin arm of the study, 5.7 months versus 3.9 months. This means that the mesothelioma patients who received both drugs had their tumors return a median of 1.8 months longer versus those who only got one drug.

Like most chemo drugs, pemetrexed kills blood cells so the most common adverse events were neutropenia, fatigue, leukopenia, nausea, dyspnea, and vomiting.

On February 4, 2004, pemetrexed was approved by the FDA in combination with cisplatin for the treatment of patients with malignant pleural mesothelioma whose disease is inoperable or who are otherwise not candidates for curative surgery.

Related Posts

Mesothelioma Tumor Response to Nivolumab Detailed in New Case Study- An Indian woman in still alive two years after a mesothelioma diagnosis thanks to a remarkable mesothelioma tumor response to nivolumab. Nivolumab is sold under the brand name Opdivo. It is a type of immunotherapy. Nivolumab is sometimes used for lung cancer that progresses after chemotherapy. A hospital in Mumbai tried nivolumab on a pleural mesothelioma patient after several types of chemotherapy did not work. Doctors say the mesothelioma tumor response to nivolumab was so great that the patient no longer needed supplemental oxygen.  Opdivo in Mesothelioma Treatment Opdivo is not FDA-approved for mesothelioma treatment. Only Alimta (pemetrexed) holds that designation. But pleural mesothelioma grows quickly and is hard to treat. Even the gold standard therapies often do not work … Continue reading Mesothelioma Tumor Response to Nivolumab Detailed in New Case Study »

Effect of Chemotherapy on Immunotherapy for Mesothelioma- Belgian scientists say they are still not sure about the effect of chemotherapy on immunotherapy for mesothelioma. They reached that conclusion after testing several different chemotherapy drugs on mesothelioma cells in the lab. The combination of chemotherapy and immunotherapy is “chemoimmunotherapy”. It aims to harness the unique powers of each treatment approach. A meta-analysis last May called chemoimmunotherapy the “next frontier” in mesothelioma treatment.  But the new Belgian study on the effect of chemotherapy on immunotherapy highlights how much doctors still do not know about the combo. Immune Checkpoints Are the Key When it is working properly, the immune system is supposed to find and kill cancer cells before they become mesothelioma tumors. But mesothelioma cells can hide from the … Continue reading Effect of Chemotherapy on Immunotherapy for Mesothelioma »

Isolated Thoracic Perfusion for Mesothelioma Symptom Relief- A new study suggests that a treatment called isolated thoracic perfusion could help alleviate some of the worst symptoms of malignant pleural mesothelioma. Isolated thoracic perfusion is a method for circulating medicine in just one area of the body. When doctors circulated chemotherapy drugs in the chests of people with pleural mesothelioma, their symptoms went away for several months.  Now, the team says it is time to test the technique in a bigger pool of mesothelioma patients.  The Theory Behind ITP Pleural mesothelioma is a membrane cancer that occurs in the chest. Chemotherapy drugs like Alimta can be powerful weapons against pleural mesothelioma. But they can also damage healthy tissues.  When healthy tissues are damaged by chemotherapy, mesothelioma patients can … Continue reading Isolated Thoracic Perfusion for Mesothelioma Symptom Relief »

Unresectable Peritoneal Mesothelioma Becomes Operable After Bi-Directional Chemotherapy- French researchers have successfully operated on a man with unresectable peritoneal mesothelioma after treating him with bi-directional chemotherapy. Chemotherapy is the most common treatment for unresectable peritoneal mesothelioma. Most mesothelioma patients have chemotherapy by IV infusion. But some cancer centers now offer another chemotherapy delivery method. Intraperitoneal chemotherapy bypasses the bloodstream. It lets doctors put higher doses of cancer-killing medicine at the site of a tumor. The French team combined the two types of chemotherapy in one patient. It shrunk the patient’s unresectable peritoneal mesothelioma tumor enough to perform surgery.  Two Types of Mesothelioma Chemotherapy With IV chemotherapy, medicine travels to the tumor through the bloodstream. It is one way of treating unresectable peritoneal mesothelioma. One drawback of IV chemotherapy … Continue reading Unresectable Peritoneal Mesothelioma Becomes Operable After Bi-Directional Chemotherapy »

Cediranib for Mesothelioma: VEGF Inhibitor Fails Another Trial- Cediranib for mesothelioma appears to be ruled out by another failed clinical trial.  A new study led by MD Anderson researchers concludes that the VEGF inhibitor causes too many side effects for not enough survival benefit.  It is a blow to researchers hoping to use cediranib for mesothelioma patients on chemotherapy.  Cutting Off Tumor Blood Supply Cediranib is an oral drug made by AstraZeneca. It is part of a class of drugs called VEGF inhibitors. Vascular endothelial growth factor (VEGF) is a signal protein that stimulates blood vessel formation in tumors. Research shows that mesothelioma patients who have higher serum levels of VEGF have a lower chance of survival.  VEGF inhibitors like cediranib latch onto VEGF receptors inside mesothelioma cells. … Continue reading Cediranib for Mesothelioma: VEGF Inhibitor Fails Another Trial »

First-Line Chemotherapy for Peritoneal Mesothelioma- The same drugs doctors use to treat pleural mesothelioma can provide effective chemotherapy for peritoneal mesothelioma, too. Japanese researchers reviewed the cases of 29 peritoneal mesothelioma patients. These patients had first-line treatment with cisplatin and pemetrexed between 2001 and 2016. The results suggest these drugs are safe and potent chemotherapy for peritoneal mesothelioma. The finding may help doctors and patients make better treatment decisions. Treating Malignant Mesothelioma Malignant mesothelioma is a membrane cancer. It usually occurs in one of two places. About 80 percent of mesothelioma tumors arise on the membrane that surrounds the lungs (the pleura). This is called pleural mesothelioma.  About 20 percent of the 2,500 cases of mesothelioma diagnosed in the US each year are peritoneal. Peritoneal … Continue reading First-Line Chemotherapy for Peritoneal Mesothelioma »

Immunotherapy Vaccine for Mesothelioma Shows Promise in Combination Treatment- A bacteria-based immunotherapy vaccine for mesothelioma may improve the odds of surviving the disease by boosting the effects of chemotherapy.  That is the word from the latest clinical trial of CRS-207 headed by researchers at the National Cancer Institute. Thirty-five inoperable patients received the immunotherapy vaccine for mesothelioma along with standard mesothelioma chemotherapy. Eighty-nine percent of them experienced either a full or partial response to the treatment combination.  CRS-207 Immunotherapy Vaccine for Mesothelioma CRS-207 is based on a modified version of Listeria monocytogenes. The bacterium is best known for causing the food borne illness Listeriosis. In CRS-207, the bacteria has been changed so it cannot make patients sick. The immunotherapy vaccine for mesothelioma uses the bacteria to trigger a powerful … Continue reading Immunotherapy Vaccine for Mesothelioma Shows Promise in Combination Treatment »

Mesothelioma Chemotherapy with Avastin Helps Pain, Neuropathy- New evidence suggests that supplementing standard mesothelioma chemotherapy with Avastin (bevacizumab) may lead to less pain. It may also reduce the risk of another mesothelioma complication called peripheral neuropathy. That word comes from a newly-published study involving several French hospitals. The study is a follow-up to the French-led MAPS study from 2016. The MAPS study showed that performing mesothelioma chemotherapy with Avastin – in addition to the standard chemotherapy drugs – improved mesothelioma survival by 23 percent. Now it looks like the three-drug combination can also help mesothelioma patients live longer with fewer side effects. Mesothelioma Complications and Side Effects Avastin is a VEGF inhibitor. It works by preventing the formation of blood vessels that feed a growing tumor. The … Continue reading Mesothelioma Chemotherapy with Avastin Helps Pain, Neuropathy »

Gel-Based Mesothelioma Treatment: A Novel Approach to Pleural Mesothelioma- Swiss scientists are developing a novel gel-based mesothelioma treatment for people with pleural disease. Early studies suggest it may be a safer way to deliver cancer-fighting drugs with fewer side effects. The gel-based mesothelioma treatment combines the chemotherapy drug cisplatin with a natural “glue” called fibrin. When the gel is applied during surgery, it can keep fighting tumors for months. Why Develop a Gel-Based Treatment? Cisplatin is a platinum-based drug. Together with pemetrexed (Alimta), it is one of the most common chemotherapy drugs for mesothelioma. In the past decade, doctors came up with a way to increase the effectiveness of cisplatin in people with peritoneal mesothelioma. These patients get chemotherapy the usual way. But they also get a rinse of … Continue reading Gel-Based Mesothelioma Treatment: A Novel Approach to Pleural Mesothelioma »

Treating Advanced Peritoneal Mesothelioma with Spray-On Oxaliplatin- European doctors have tested a new spray-on cancer drug that could be another treatment option for people with advanced peritoneal mesothelioma. The drug is oxaliplatin. It is sold under the brand name Eloxatin. It is normally given by injection into a vein. But that can cause serious side effects, including stomach pain. A new study published in the European Journal of Surgical Oncology suggests there may be a more effective way to get the benefits of oxaliplatin. Researchers found that using it as a spray for advanced peritoneal mesothelioma extended survival with fewer side effects. PIPAC for Advanced Peritoneal Mesothelioma As Surviving Mesothelioma first reported last spring, pressurized intraperitoneal aerosol chemotherapy (PIPAC) is a new way to deliver cancer medicines. … Continue reading Treating Advanced Peritoneal Mesothelioma with Spray-On Oxaliplatin »