Chemotherapy is medicine prescribed by your doctor to treat cancer.  The purpose can be to kill the cancer cells and cure the patient, keep the cancer from spreading, slow the growth of the cancer, reduce the size of the cancer so that surgery can then be done, relieve pain from the cancer.

The way chemotherapy works varies from drug to drug.  Some work by stopping the growth of cancer cells, either by killing the cells or by stopping them from dividing.

For mesothelioma chemotherapy can be given, for most patients, either by vein –I.V. – known as systemic therapy.  Some patients are also treated with chemotherapy placed directly in the affected body cavity such as the chest in pleural mesothelioma or abdominal cavity in peritoneum mesothelioma.  These treatments are decided upon by the stage and type of the disease that the patient has.  This type of specialized chemotherapy is regional chemotherapy.

On February 4, 2004 the FDA approved Pemextred Disodium for Injection- Alimta- in combination with Cisplatin for treatment of patients with malignant pleural mesothelioma. Used together the combination of Pemextred Disodium plus Cisplatin is designed to produce bone marrow suppression.

These two drugs remain the first line chemotherapy drugs today.

Cisplatin:

  • First created in mid-19th Century and is also known as Peyrone’s chloride after the discoverer of the drug Michael Peyrone
  • First went into clinical trials for cancer therapy in 1971
  • Called “the penicillin of cancer”
  • Frequently given as part of a combination chemotherapy regimen with other drugs

Pemetrexted:

  • Pemetrexed is an ant folate, a substance that blocks the activity of folic acid.
  • Developed by Edward C. Taylor at Princeton University and clinically developed by Eli Lilly and Company in 2004.
  • Works by inhibiting the formation of precursor purine and pyrimidine nucleotides, prevents the formation of DNA and RNA, required for the growth and survival of both normal cells and cancer cells.
  • Patients are required to be on folic acid and vitamin B12 supplementation when they are on Pemetrexed therapy.  Also recommended for patients to be on steroid therapy on the day prior, day of, and day after Pemetrexed infusion to avoid skin rashes.

Chemotherapy has side effects, although there has been great progress in controlling them over the past few years.