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Pemetrexed is marketed by Eli Lilly and Company under the brand name Alimta. It is the most effective chemotherapy drug for mesothelioma. Doctors often combine Alimta with platinum-based drugs such as cisplatin and carboplatin to increase its effectiveness.
Written by Karen Selby, RN • Edited By Walter Pacheco • Medically Reviewed By Dr. Arkadiusz Z. Dudek
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Selby, K. (2023, June 21). Alimta. Asbestos.com. Retrieved December 5, 2023, from https://www.asbestos.com/treatment/chemotherapy/alimta/
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Selby, Karen. "Alimta." Asbestos.com. Last modified June 21, 2023. https://www.asbestos.com/treatment/chemotherapy/alimta/.
The U.S. Food and Drug Administration approved Alimta to treat cancer. It treats nonsquamous non-small cell lung cancer and malignant mesothelioma.
Doctors have prescribed chemotherapy to treat mesothelioma cancer for decades. Few chemotherapy drugs have had as much of an effect as Alimta.
Alimta stands out as having the most promise in prolonging mesothelioma life expectancy. It also improves quality of life by reducing breathing difficulty and chest pain.
It is a medication that blocks DNA replication and cell division. This action causes mesothelioma cells to die rather than grow.
The first phase I study of Alimta for mesothelioma completed in 1999. It combined Alimta and cisplatin for mesothelioma. The study proved the effectiveness of these drugs against this cancer.
In 2004, the FDA approved Alimta with cisplatin for the treatment of malignant pleural mesothelioma. The results of a phase III clinical trial by Dr. Nicholas J. Vogelzang led to approval.
This study inspired other mesothelioma specialists, such as Dr. Hedy Kindler, to further study Alimta.
Alimta works by stopping cancer cells from rapidly dividing. It blocks the production of folate and stops the division and replication of mesothelioma cells.
This action causes the cancer cells to die instead of grow.
Alimta belongs to a class of drugs called antimetabolites. Because it blocks folate, it is considered an antifolate antimetabolite.
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Alimta and cisplatin are combined to improve survival.
This is the only FDA-approved chemotherapy regimen for mesothelioma.
Alimta and cisplatin are the most commonly prescribed drugs for first-line mesothelioma chemotherapy. They help mesothelioma patients live around one year. Without them, most patients survive an average of four months.
One clinical trial showed that patients taking the combination survived 13.3 months. Patients who only received cisplatin lived 10 months.
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 |
Clinical trials are researching more effective drug combinations to treat mesothelioma. Alimta is used as the baseline chemotherapy drug for these combinations.
Promising clinical trials involving Alimta include:
In 2016, the National Comprehensive Cancer Network changed its first-line treatment recommendation for inoperable pleural mesothelioma.
NCCN added the monoclonal antibody bevacizumab to the Alimta and cisplatin combination. Bevacizumab is an anti-angiogenesis drug. This kind of drug blocks mesothelioma from spreading.
The Alimta and cisplatin combo has been the standard-of-care regimen for mesothelioma since 2004. The FDA may approve bevacizumab following the NCCN’s recommendation.
A 2017 study published in Expert Review of Anticancer Therapy showed Alimta and cisplatin are also effective in controlling peritoneal mesothelioma. For peritoneal patients who don’t qualify for surgery, Alimta and cisplatin may be administered systemically to extend survival and reduce symptoms.
The recommended dose of Alimta is 500 mg/m². It is administered through injection into an IV line. It only takes about 10 minutes to administer each dose.
Cisplatin is typically infused over two hours. Infusion begins approximately 30 minutes after the Alimta dose. This cycle is repeated every three weeks. It is up to the mesothelioma specialist to determine how many cycles a patient receives.
Alimta may be used by itself as a second-line therapy when the cancer relapses. It is also used as a maintenance treatment to prolong remission.
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.
The most common side effects of Alimta as a single-agent treatment include:
When combined with cisplatin, more than 20% of patients experience:
Mesothelioma patients should avoid being near people who have colds, the flu or other signs of illness.
Be sure to contact your doctor right away if you develop signs of infection. Tell your doctor before receiving Alimta if you are taking an NSAID to avoid a drug interaction. NSAIDs include ibuprofen, naproxen, indomethacin or ketoprofen.
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 precaution.
Alimta changed the landscape of mesothelioma treatment in the early 2000s. Prior to 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.
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