Alimta as Maintenance Therapy May Extend Survival in Mesothelioma Patients
The mesothelioma community closely watches for any study that results in a better quality of life or extended survival for mesothelioma patients. With no cure and limited survival, mesothelioma is challenging to treat and patients are faced with a grim prognosis. Now, researchers in Japan report that the chemotherapy drug Alimta, when used as maintenance therapy, could be the next standard of treatment.
Nearly 3, 000 Americans are diagnosed with mesothelioma each year and approximately the same number will die from the disease annually. There is no cure for the disease, and the aggressive nature of the cancer often results in recurrence after the initial treatment of chemotherapy, typically Alimta (pemetrexed) used in combination with Cisplatin.
Often, a second round of chemotherapy is ordered when the tumor returns. However, chemotherapy is notorious for its side effects including low blood cell counts, diarrhea, nausea and vomiting. Cisplatin is also known to cause kidney damage or failure in about 30 percent of users, according to researchers at the Georgia Health Sciences University.
In order to get around the chemotherapy toxicity issues in one mesothelioma patient who had received five rounds of the combination treatment of cisplatin/Alimta, researchers in Japan dropped the cisplatin from the second round and administered a higher total dose of pemetrexed. The resulting pemetrexed maintenance therapy (PMT) was used, and after 18 cycles of PMT, “the patient achieved a complete response.”
The researchers concluded: “although the standard of care for MPM [malignant pleural mesothelioma] is the combination of cisplatin and pemetrexed and PMT still remains experimental, the adoption of PMT following cisplatin-based induction chemotherapy appears very promising, and further investigation is urgently needed.”
Pemetrexed Disodium (Alimta) was approved by the FDA in 2004 for the treatment of malignant pleural mesothelioma. Specifically, the approved orphan indication is for treatment of patients with malignant pleural mesothelioma whose disease is either unresectable or who are otherwise not candidates for curative surgery. Used in combination with cisplatin, the combination increases the effectiveness of treatment when surgery is not possible.
In 2011, the FDA approved continuation maintenance of Alimta alone following first-line treatment of the combination of Alimta plus Cisplatin for locally advanced or metastatic nonsquamous non-small cell lung cancer. Phase III data had demonstrated progression-free and overall survival advantages in the continuation maintenance therapy.