Alimta® and Paraplatin® Effective in Elderly with Mesothelioma

Researchers from Italy have reported that the combination of Alimta® (pemetrexed) and Paraplatin® (carboplatin) is effective palliative therapy for elderly patients with mesothelioma. The details of this study appeared in an early online publication in the British Journal of Cancer on June 10, 2008.

Pleural mesothelioma is a rare and lethal form of cancer caused by asbestos exposure. There are about 2,500 new cases per year in the United States. Because the disease is often advanced at the time of diagnosis, average survival for those with pleural mesothelioma has been significantly less than one year. Recent studies have suggested that chemotherapy can improve quality of life and prolong survival compared with supportive care measures. However, some researchers have questioned the benefit of chemotherapy compared with supportive care alone (see first item of related news).

At the 12th World Conference on Lung Cancer in September, 2007, there were two studies presented on the treatment of malignant mesothelioma with Alimta (see second item of related news). The combination of Alimta and Paraplatin was found to have an overall response rate of 22%, a disease control rate of 76%, a one-year survival rate of 64%, and a median time to disease progression of seven months.

The current study evaluated Alimta and Paraplatin in 178 patients with malignant pleural mesothelioma. The median age was 65 years, and 48 patients were 70 years of age or older. There were more severe hematologic toxicities in patients 70 years of age or older compared with younger patients. Disease control was 60% in the more elderly group compared with 67% in the younger group. Time to disease progression was 7.2 months versus 7.5 months, and median survival was 10.7 versus 13.9 months for the older age group versus the younger age group, respectively. These authors concluded that this regimen was equally effective in patients over 70 years of age as in younger patients with slightly worse hematologic toxicity.

Comments: These data support the concept that age is not a contraindication to palliative chemotherapy with Alimta and Paraplatin for patients with inoperable mesothelioma.

Related News:

Chemotherapy May Not Affect Survival or Quality of Life for Patients with Advanced Mesothelioma (5/21/2008)

Results of Alimta® for Treatment of Malignant Pleural Mesothelioma Reported (10/31/2007)

Reference:

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¹ Ceresoli GI, Castagneto B, Zucali PA, et al. Pemetrexed plus carboplatin in elderly patients with malignant pleural mesothelioma: combined analysis of two phase II trials. British Journal of Cancer [early online publication]. June 10, 2008.

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