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Alimta
Table Of Contents
Eli Lilly and Company markets pemetrexed under the brand name Alimta. It's 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 | Medically Reviewed By Dr. Arkadiusz Z. Dudek | Edited By Walter Pacheco | Last Update: July 25, 2024
Written by Karen Selby, RN | Medically Reviewed By Dr. Arkadiusz Z. Dudek | Edited By Walter Pacheco | Last Update: July 25, 2024
What Is 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 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 |
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.
It’s a medication that blocks DNA replication and cell division. This action causes mesothelioma cells to die rather than grow.
When Was Alimta Approved for Mesothelioma?
In 2004, the FDA approved Alimta with cisplatin for the treatment of 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, such as Dr. Hedy Kindler, to further study Alimta.
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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.
How Alimta Attacks Mesothelioma
Alimta stops 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’s considered an antifolate antimetabolite.
Alimta and Cisplatin for Mesothelioma
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 4 months.
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.
Dr. Jennifer M. Suga, oncologist at Kaiser Permanente Medical Center in California
One clinical trial showed that patients taking the combination survived 13.3 months. Patients who only received cisplatin lived 10 months.
Mesothelioma Chemotherapy and Alimta Research
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:
- A 2016 phase III clinical trial added Avastin (bevacizumab) to cisplatin and Alimta with a positive impact on overall survival. Pleural mesothelioma patients who received all 3 drugs lived an average of 18.8 months compared to 16.1 months among those who only received cisplatin and Alimta.
- 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.
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. 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 Avastin following the NCCN’s recommendation.
Alimta for Peritoneal Mesothelioma
A recent 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 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.
Alimta Dosage and Treatments
The recommended dose of Alimta is 500 mg/m². It’s administered through injection into an IV line. It only takes about 10 minutes to administer each dose.
Cisplatin is typically infused over 2 hours. Infusion begins approximately 30 minutes after the Alimta dose. This cycle is repeated every 3 weeks. It’s up to the mesothelioma specialist to determine how many cycles a patient receives.
Alimta may be used alone as a second-line therapy when the cancer relapses. It’s also used as a maintenance treatment to prolong remission.
Survivor Story
Survivor Story
Kevin Hession
Pleural Mesothelioma
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 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 precaution.
The most common side effects of Alimta as a single-agent treatment include:
- Anorexia
- Fatigue
- Nausea
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’re taking an NSAID to avoid a drug interaction. NSAIDs include ibuprofen, naproxen, indomethacin or ketoprofen.
Side Effects of Alimta With Cisplatin
In addition to Alimta’s side effects, when combined with cisplatin, patients may experience additional side effects. 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.
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 changed the landscape of mesothelioma treatment in the early 2000s. Prior to its FDA approval, mesothelioma patients had few options to extend their survival.
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