What Is Alimta?

Alimta (pemetrexed) is a chemotherapy drug for non-squamous non-small cell lung and mesothelioma cancer. Doctors have successfully prescribed it to non-squamous NSCLC and mesothelioma patients for decades. Since the U.S. Food and Drug Administration approved it to treat cancer, few chemotherapy drugs have had as much of an effect as Alimta.

For many patients, Alimta stands out as having the most promise in prolonging mesothelioma life expectancy. It also improves quality of life, reducing breathing difficulty and chest pain. This medication blocks DNA replication and cell division, killing mesothelioma cells.

Alimta Information

Doctors can use Alimta alone or in combination with other drugs to treat mesothelioma. Alimta is an antimetabolite drug that disrupts the normal biological breakdown of chemicals used during metabolism.

Alimta Information
Name Pemetrexed
Alternate Names Alimta
First Mesothelioma Clinical Trial 1999
Types of Mesothelioma Treated Pleural and peritoneal mesothelioma
Stages of Mesothelioma Stages 1 through 4
Commonly Paired with Cisplatin and carboplatin
Ongoing Trials Pemetrexed Disodium/Observation in Treating Patients with Malignant Pleural Mesothelioma Without Progressive Disease After 1st Line Chemotherapy
Medical Studies Study of Cytoreductive Surgery and Hyperthermic Intraoperative Chemotherapy with Pemetrexed and Cisplatin for Malignant Pleural Mesotheliomas

Patients who are pregnant shouldn’t take Alimta because it could harm the unborn baby. If you’re considering Alimta, tell your doctor if you have kidney or liver disease, a weak immune system or excess fluid in your chest cavity.

How Does Alimta Treat Mesothelioma?

Alimta prevents cancer cells from rapidly dividing. It also blocks the production of folate and stops the division and replication of mesothelioma cells, causing them to die instead of grow. Because it blocks folate, Alimta is considered an antifolate antimetabolite.

The recommended dosage for Alimta is 500 mg/m2, administered through a port or an intravenous line over 10 minutes. The guidelines recommend 21 days, or a cycle, between each IV infusion.

Kevin Hession
Verified Asbestos.com Survivor
Mesothelioma Survivor Describes His Success With Chemotherapy

Pleural mesothelioma survivor Kevin Hession says he actually gained weight following his chemotherapy treatments. “I’ve never had a bad experience with chemotherapy,” Kevin said. “My worst case on a scale of 1 to 10 has probably been a 3.” His treatments have gone so well he was offered an option to take what he calls a “chemo holiday,” allowing him to skip a round.

Alimta Treatment for Pleural Mesothelioma

Doctors often combine Alimta with cisplatin to improve survival in pleural mesothelioma patients. Pleural mesothelioma affects the lining of the lungs and chest wall. Alimta can help slow growth and kill cells that contribute to the effects of cancer, such as chest pain, shortness of breath and cough.

Doctors often pair platinum drugs with pemetrexed, known by its brand name Alimta. Pemetrexed is thought to be the most active mesothelioma chemotherapy drug. Combining pemetrexed with platinum drugs showed over 20% improvement in treatment response with more growth control and survival time.

This is the only FDA-approved chemotherapy regimen for mesothelioma. Alimta and cisplatin are the most commonly prescribed drugs for first-line pleural mesothelioma chemotherapy. They help mesothelioma patients live for around one year. Without them, most patients survive an average of 4 months.

Alimta Treatment for Peritoneal Mesothelioma

Alimta isn’t a standard therapy for peritoneal mesothelioma. It may be part of a multimodal approach that includes cytoreductive surgery and hyperthermic intraperitoneal chemotherapy. Although Alimta is only approved for pleural mesothelioma, doctors may use it for some patients based on clinical evidence.

Multiple clinical trials are recruiting patients with peritoneal mesothelioma to test the effectiveness of Alimta in certain situations, such as after surgeries like HIPEC. These studies may lead to more practical uses of Alimta for peritoneal mesothelioma that can provide improved survival and symptom relief.

The chemotherapy did what it was intended to do and it killed the cancer. Since the HIPEC procedure, I have not had any cancer recurrences. I’m a 15-year and counting survivor.

Tamron Little Mesothelioma Survivor

Alimta for Asbestos-Related Lung Cancer

Doctors prescribe Alimta for patients with NSCLC after prior chemotherapy. The drug also comes in an injectable form, which can treat patients with a new diagnosis of locally advanced or metastatic non-squamous NSCLC.

The first phase I study of Alimta for mesothelioma was completed in 1999. It combined Alimta and cisplatin for mesothelioma and proved the effectiveness of these drugs against this cancer.

Alimta Side Effects

The side effects of Alimta are usually mild to moderate for most patients. Some patients may experience extreme side effects. A doctor should be informed immediately if a reaction becomes a serious problem.

Patients with certain conditions should consult their doctor about the risks and benefits of taking Alimta. Anyone with kidney disease, liver disease, a weak immune system or excess fluid in the space around their lungs, liver or other internal organs should take precautions.

Common Side Effects of Alimta as Single Agent

  • Anorexia
  • Fatigue
  • Nausea

Mesothelioma patients should avoid being near people with colds, the flu or other signs of illness. If they develop signs of infection, they should contact their doctor immediately.

Tell your doctor before receiving Alimta if you’re taking a non-steroidal anti-inflammatory drug to avoid a drug interaction. NSAIDs include ibuprofen, naproxen, indomethacin and ketoprofen.

Side Effects of Alimta With Cisplatin

In addition to Alimta’s side effects, patients may experience additional side effects when combined with cisplatin. More than 20% of patients taking Alimta in combination with cisplatin report experiencing the following: Anemia (deficiency of red blood cells), constipation, low blood platelet count (thrombocytopenia), low or reduced white blood cell count, sores and swelling in the mouth and throat and vomiting.

Side effects of alimta and cisplatin
Diagram shows the most common side effects of using Alimta with cisplatin.

Alimta changed the landscape of mesothelioma treatment in the early 2000s. Before its FDA approval, mesothelioma patients had few options to extend their survival.

Researchers continue to test Alimta in combination with new drugs. Their goal is to find the most effective ways to use it to improve the lives of people with mesothelioma.

Alimta Research

Clinical trials are researching more effective drug combinations to treat mesothelioma. Alimta is used as the baseline chemotherapy drug for these combinations.

The National Comprehensive Cancer Network changed its first-line treatment recommendation for inoperable pleural mesothelioma in 2016. NCCN added the monoclonal antibody Avastin (bevacizumab) to the Alimta and cisplatin combination. Avastin is an anti-angiogenesis drug that blocks mesothelioma from spreading.

Promising clinical trials involving Alimta include:

  • A 2023 phase II clinical trial is testing Alimta in pleural mesothelioma patients before treating them with surgery and radiation.
  • In a study of Tumor Treating Fields with Alimta and cisplatin or carboplatin, a median survival of 18.2 months was demonstrated. This study led to the approval of TTFields for treatment of mesothelioma.
  • In a trial studying the combination of cisplatin and Alimta with the immune checkpoint inhibitor Imfinzi (durvalumab), 57% of patients had no mesothelioma progression at 6 months. This combination is now being studied in a large phase III trial.

In 2004, the FDA approved Alimta with cisplatin for treating malignant pleural mesothelioma. The results of Dr. Nicholas J. Vogelzang’s phase III clinical trial led to its approval. This study inspired other mesothelioma specialists like Dr. Hedy Kindler to study Alimta further.

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