Report Suggests Popular Mesothelioma Drug May Not Be Best Value, According to Surviving Mesothelioma

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Researchers in The Netherlands say the most popular drug for malignant pleural mesothelioma may not be the most cost-effective drug for the job.

As yet, platinum-doublet therapy is the most effective palliative treatment for MPM.

In a paper published in Anticancer Research and reported by Surviving Mesothelioma, an Amsterdam-based research team reviewed the medical literature on pemetrexed (Alimta), the first FDA-approved drug for mesothelioma, as well as other newer drugs and drug combinations. Although all of the anti-cancer agents studied, including pemetrexed, raltitrexed, gemcitabine and vinorelbine, have some level of effectiveness against mesothelioma (there is currently no cure), some were much less expensive than others.

Since its approval in 2004, pemetrexed in combination with a platinum-based agent like cisplatin [referred to as a ‘platinum doublet’] has become the standard of care for mesothelioma patients, particularly for those who are not candidates for surgery. But a 2012 study published in Lung Cancer found that the less-expensive raltitrexed/cisplatin combination also increased mesothelioma survival. The authors of the new report cite studies showing good response rates with vinorelbine and gemcitabine combinations, both of which, in contrast to pemetrexed, are available in less expensive generic forms.

According to the authors, platinum doublets like pemetrexed/cisplatin, which inhibits enzymes necessary for cancer growth, are “the most effective palliative treatment” for malignant pleural mesothelioma. But they say more study is needed to determine which platinum doublets will achieve the best response at the lowest cost.

“Further research should include randomized controlled trials comparing the recommended pemetrexed-cisplatin directly with platinum doublets with raltitrexed, gemcitabine or vinorelbine,” they write. The original report appears in a recent issue of Anticancer Research. (Boons, CC, et al, “The value of pemetrexed for the treatment of malignant pleural mesothelioma: a comprehensive review,” September 2013, Anticancer Research, pp. 3553-3561.

For nearly ten years, Surviving Mesothelioma has brought readers the most important and ground-breaking news on the causes, diagnosis and treatment of mesothelioma. All Surviving Mesothelioma news is gathered and reported directly from the peer-reviewed medical literature. Written for patients and their loved ones, Surviving Mesothelioma news helps families make more informed decisions.

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Michael Ellis
Cancer Monthy
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