Researchers from Italy have reported that Alimta® (pemetrexed), with or without a platinum compound, is active and well tolerated in patients with peritoneal mesothelioma. The details of this study appeared in the May 1, 2009 issue of Lung Cancer.[1]
Peritoneal mesothelioma is much less common than pleural mesothelioma, making up less than 20% of all cases. The total number of cases in the United States per year is estimated to be between 100 and 500. The latency period for abdominal mesothelioma appears to be 20-30 years, which is shorter than the latent period for pleural mesothelioma. Controlled trials of various treatment options are not available for peritoneal mesothelioma due to the relative rarity of this disease. The most common treatment strategy for peritoneal mesothelioma involves a multimodality approach with surgical debulking followed by systemic and/or intraperitoneal chemotherapy. The role of radiation therapy is not well documented. Researchers from Columbia University have recently reported that combined resection, intraperitoneal chemotherapy, and whole abdominal radiation therapy may be the most effective strategy for palliative therapy for malignant peritoneal mesothelioma. Researchers affiliated with a multicenter U.S. trial have reported that the combination of Alimta and Gemzar® (gemcitabine) was active in patients with peritoneal mesothelioma.
The Italian study included 109 patients with peritoneal mesothelioma who had not received prior chemotherapy and were deemed not suitable for surgery. Patients in this study received Alimta alone, Alimta plus Platinol® (cisplatin), or Alimta plus Paraplatin® (carboplatin).
- Alimta alone: The response rate was 12.5%, the one-year survival rate was 41.5%, and the median survival was 10.3 months.
- Alimta plus Platinol: The response rate was 20%, and the one-year survival was 57.4%.
- Alimta plus Paraplatin: The response rate was 24%, and survival rates were not reported.
The most common side effects were anemia and neutropenia. These authors concluded that Alimta, with or without a platinum agent, was active and well tolerated in patients with peritoneal mesothelioma.
Comments: These data would suggest that Alimta and Paraplatin could be the treatment of choice for patients with peritoneal mesothelioma, as it may also be for patients with pleural mesothelioma.
Reference:
[1] Carteni G, Manegold C, Garcia GM, et al. Malignant peritoneal mesothelioma-Results from the International Expanded Access Program using pemetrexed alone or in combination with a platinum agent. Lung Cancer. 2009;64:211-218.
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