German mesothelioma researchers recently published a study on the effects of Pemetrexed in the journal Respiratory Medicine. The study found the chemotherapeutic drug to be safe and active as first and second-line chemotherapy for mesothelioma patients.
This study comes from an international expanded access program that was started to provide access to treatment results with Pemetrexed in malignant mesothelioma patients. Patients eligible for the study included pretreated patients, those without prior chemotherapy and patients with inoperable malignant mesothelioma of the pleura or peritoneum.
The study included treatment with Pemetrexed alone or in combination with cisplatin or carboplatin. Of the 548 eligible patients with pleural mesothelioma, 191 received Pemetrexed alone, 137 received Pemetrexed with cisplatin, and 220 received Pemetrexed with carboplatin.
Patients in the Pemetrexed only group were more frequently pretreated and had worse performance status when compared with other patient groups. The Pemetrexed only group exhibited an overall response rate (ORR) of 16 percent. The Pemetrexed plus cisplatin group showed an ORR of 24 percent and the Pemetrexed plus carboplatin group presented an ORR of 18 percent.
Median survival rate for the Pemetrexed only group was 8.7 months, the lowest rate out of the three groups. Median survival for the Pemetrexed plus cisplatin group was 11.3 months and median survival for the Pemetrexed plus carboplatin group was 9.7 months.
Researchers found the efficacy outcomes were better in patients without prior chemotherapy than in pretreated patients. Though combination treatment with cisplatin or carboplatin improved median survival, treatment with Pemetrexed alone was less hematotoxic (poisonous to the blood).
The authors of the study found, “In conclusion, our results obtained in the German patient population of an international expanded access program are largely consistent with the experience in other … clinical studies of malignant mesothelioma. It was shown that pemetrexed given alone or in combination with cisplatin or carboplatin is safe and effective as first and second-line therapy in pleural mesothelioma. In particular, single agent pemetrexed could be a valuable treatment option for pretreated patients which may offer substantial clinical benefit. Preliminary evidence suggests that pemetrexed-based chemotherapy has similar activity in peritoneal mesothelioma.”
Additional information about mesothelioma and chemotherapy may be found through the mesothelioma Center.