Alimta (Pemetrexed) Mesothelioma Treatment

Alimta, also called Pemetrexed, is a new treatment made by Eli Lilly designed to treat people with mesothelioma. The drug has just undergone an extensive test phase involving many patients with this cancer. The clinical trials which involved 456 people were the largest ever conducted for a mesothelioma treatment.

The findings of this study were reported at the annual meeting of the American Society of Clinical Oncology held in May, 2002. According to the study, many patients on Alimta lived longer and experienced less pain than those on alternative cancer treatments.

The physician who authored the study was Nicholas J. Vogelzang, M.D. from the University of Chicago Cancer Research Center. In a statement released by Eli Lilly, the maker of Alimta, Doctor Vogelzang stated:

This is the largest clinical trial ever conducted in this disease and the 25 to 30 percent improvement in survival for patients on the combination therapy is the first time anyone has documented a significant improvement in patients treated for mesothelioma.

How does it work?

Alimta is what is called an antifolate (also sometimes called a folic acid antagonist or folate analog). Folic acid is a B-vitamin that the body uses to build cells. In people with cancer, folic acid can stimulate tumor growth. Researchers studying people with Leukemia found that folic acid seemed to increase the growth and numbers of cancer cells. After this discovery, doctors who specialize in cancer treatment theorized that compounds that interfered with folic acid production in the body may help fight cancer.

This discovery was proven in subsequent tests. Thus compounds like Alimta can be used to interfere and inhibit the creation of folic acid. This in turn stops the body from using the folic acid to make more cells, helping to stop rapidly growing cancer cells.

The researchers use technical terms to describe this process, saying Alimta "targets the folic acid metabolic pathway, which effects availability of certain B complex vitamins." As explained above what this means is simply that Alimta prevents the body from making Folic acid, which in turn checks the growth of tumors.

The clinical trial showed that this is the case. In people given Alimta, the mesothelioma tumors shrank in 41 percent of patients. (Alimta was given in combination with another chemotherapy agent called cisplatin.)

However, the tumors became smaller in only 17 percent of patients receiving cisplatin without Alimta. The study also concluded, people taking the Alimta lived nearly three months longer than people taking only cisplatin.

On the down side, the body still needs Folic acid (indeed many pregnant woman take it to prevent birth defects). By interfering with its growth, many patients, especially those already deficient in folic acid or vitamin B12, who took Alimta experienced bad side effects. The study reported they experienced severe toxicity, severe diarrhea and serious mouth ulcers.

Overall however the study was very successful. The measurable improvement in people taking Alimta is a significant advance in Mesothelioma treatment, points to the future and provides hope to patients with this terrible disease. -KWK

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