According to results recently published in the Journal of Thoracic Oncology, treatment with the chemotherapy agent Alimta® (pemetrexed) with or without the chemotherapy agent Platinol® (cisplatin) provides benefit for patients with malignant mesothelioma who have received prior therapies.
Malignant pleural mesothelioma is a rare cancer that develops in the tissue that covers the lungs and lines the interior of the chest. It is often caused by chronic exposure to asbestos. The majority of patients are not diagnosed until the disease has progressed to an advanced stage and treatment with surgery or radiation is not an option. Patients with this disease often experience symptoms, such as shortness of breath, cough, pain, fatigue, and an inability to eat, which lessen their quality of life.
Mesothelioma is fairly resistant to most therapies, including surgery, chemotherapy, and radiation therapy. Therefore, finding a chemotherapy regimen or new therapeutic approaches that can improve quality of life or survival is essential for improving care for patients with this disease.
Recurrent mesothelioma refers to cancer that has progressed or returned following prior therapies. Optimal treatment strategies that will improve long-term outcomes for patients with recurrent mesothelioma continue to be evaluated.
Researchers affiliated with the Eli Lilly and Company expanded access program (EAP) recently conducted a phase III trial to evaluate treatment including Alimta or Alimta/cisplatin forf recurrent mesothelioma. This trial included 187 patients who were treated with either Alimta or Alimta/cisplatin and were directly compared.
- Anticancer responses were achieved in 32.5% of patients treated with Alimta/cisplatin compared with 5.5% for patients treated with Alimta alone.
- Anticancer responses plus disease stabilization (disease control rate) was achieved in nearly 69% of patients treated with Alimta/cisplatin, and 47% for those treated with Alimta alone.
- Half of the patients were alive at 7.6 months among those treated with Alimta/cisplatin, compared with 4.1 months for those treated with Alimta alone.
- Serious side effects were generally rare, with dehydration and nausea being the most common.
The researchers concluded that treatment with Alimta/cisplatin or Alimta alone produces anticancer benefits among patients with recurrent mesothelioma. The combination of Alimta/cisplatin appeared to provide greater activity than Alimta alone; however, both treatment options may be considered for this challenging disease.
Patients with recurrent mesothelioma may wish to speak with their physician regarding their individual risks and benefits of treatment including Alimta, or the participation in a clinical trial evaluating other novel therapeutic approaches. Two sources of information regarding ongoing clinical trials include the National Cancer Institute (www.cancer.gov) and www.cancerconsultants.com.
Reference: Janne P, Wozniak A, Belani C, et al. Pemetrexed Alone or in Combination with Cisplatin in Previously Treated Malignant Pleural Mesothelioma: Outcomes from a Phase IIIB Expanded Access Program. Journal of Thoracic Oncology. 2006; 1: 506-512.