Within the last decade, medical researchers have developed chemotherapy into an effective treatment for mesothelioma. Today, doctors use FDA-approved chemotherapy drugs to reduce pain caused by mesothelioma. The most effective combination of mesothelioma drugs is Alimta and cisplatin. This combination was the first FDA-approved treatment for mesothelioma.
Not all patients, however, respond to certain types of chemotherapy. For instance, if a patient doesn’t respond to Alimta and cisplatin, a specialist has to prescribe a secondary chemotherapy drug.
Common Chemotherapy Drugs for Mesothelioma
Alimta and cisplatin: This is the overall most effective chemotherapy for mesothelioma. It’s the first combination to have a significant impact on survival.
Carboplatin: Carboplatin is a platinum-based chemotherapy drug similar to cisplatin. Oftentimes, doctors replace cisplatin with carboplatin if their patients are experiencing too many side effects.
Gemcitabine: Doctors may prescribe gemcitabine to patients who have developed a tolerance to Alimta.
Medical researchers are also testing new chemotherapy drugs in clinical trials. Over time, they develop these new drugs into life-extending treatments, and combine them with other experimental treatment options — some of which may lead to a cure in the future.
The Most Effective Combinations
Doctors combine chemotherapy drugs to improve their cancer-killing effectiveness. They’re currently using 2 combinations to produce the best results: Alimta and Cisplatin, and Alimta and Carboplatin.
Over the years, medical researchers have reported that combinations of Alimta and a platinum-based drug, such as cisplatin or carboplatin, are the most effective chemotherapeutic treatments to reduce pain caused by mesothelioma—and improve life expectancy. Researchers conducted a study in 2014 that demonstrated how effective the combination could be. A patient they treated with cisplatin and Alimta experienced a progression-free survival time of 22 months.
Chemotherapy Drug Profiles
Alimta (pemetrexed): Alimta is an anti-cancer drug known as an “antifolate.” After doctors introduce it into the patient’s bloodstream via IV, cancer cells absorb the drug. As soon as it enters a cell, Alimta blocks folic acid, which helps cells divide, interrupting the cell’s ability to grown and spread. Interrupting cell division causes mesothelioma cells to die, and eventually helps shrink the size of a tumor. Shrinking tumors relieves pain, and helps doctors remove them with surgery.
Side effects caused by Alimta include:
- Reduction of white and red blood cells
- Chest pain
- Reduced appetite
Doctors prescribe the intake of B12 injections—usually 7 days before the first dose of Alimta—and folic acid to prevent side effects caused by the drug.
Cisplatin (Platinol): Cisplatin is an alkylating agent doctors give to patients via slow intravenous (IV) injection. It works by attaching an alkyl group onto the DNA of mesothelioma cells. This disrupts the cell’s internal processes, and causes its death.
Cisplatin is an FDA-approved drug which has increased the life expectancy of patients with pleural and peritoneal mesothelioma. Doctors often combine it with Alimta for event better results.
Side effects caused by Cisplatin include:
- Pain, swelling, redness
Gemcitabine (Gemzar): Gemcitabine is an antimetabolite, a type of drug that replaces parts of a mesothelioma cell’s DNA. Once it replaces these parts, it stops the growth of the cancer cell, and triggers its death. Doctors typically give gemcitabine to patients intravenously (IV); they can’t use pills to administer the drug because the stomach metabolizes it very quickly, lowering its cancer-killing effectiveness.
Side effects of Gemcitabine include:
- Flu-like symptoms
- Temporary decrease in red blood cells and platelets
- Skin rash
Doxorubicin (Adriamycin/Rubex): Doxorubicin is an anti-cancer drug doctors classify as an anthracycline antibiotic. An anthracycline is an antibiotic derived from a bacteria called streptomyces, which is typically found in decaying soil. Doctors administer the drug to patients via IV. Doxorubicin works by damaging the membranes of mesothelioma cells, inhibiting their growth.
Side effects of Doxorubicin include:
- Irregular heart beats
- Swelling (especially in the feet and ankles)
- Cardiomyopathy (congestive heart failure)
Carboplatin (Paraplatin): Carboplatin is an anticancer drug doctors classify as an alkylating agent. It’s administered to patients via IV. Like cisplatin, carboplatin attaches an alkyl agent to the DNA of a mesothelioma cell. This stops the cell from dividing, and eventually causes it to die.
Side effects of Carboplatin include:
- Reduction of red blood cells, white blood cells and platelets
- Hair loss
- Changes in taste
Carboplatin causes less side effects than cisplatin, but can significantly reduce a patient’s blood cell and platelet count. Doctors typically replace it with cisplatin when they treat patients who already have low blood cell and platelet counts.
Navelbine (vinorelbine): Navelbine is a plant alkaloid, a group of drugs made from plants, specifically the periwinkle. Doctors give it to patients via IV. It works by interfering with mesothelioma cells while they divide and spread. As soon as it interferes with a mesothelioma cell’s division, the cell dies, slowing down the metastasis of a tumor.
Side effects of Navelbine include:
- Reduction in white blood cells, red blood cells and platelets
- Hair loss
New Drugs Testing in Clinical Trials
Researchers are currently testing new chemotherapy drugs in clinical trials; new drugs give patients more treatment options, and more chances to improve their prognosis. They’re also developing new combinations of chemotherapy drugs and other treatments, like surgery and radiation therapy. As these combinations improve, so will the results they produce.