Pemetrexed-cisplatin combination in mesothelioma.
Despite the desperate struggle for improvement in the therapy of malignant pleural mesothelioma in previous decades, no standard therapy could be established. Pemetrexed (Alimta), a new multitargeted antifolate, showed significant antitumor activity in combination with cisplatin compared with cisplatin alone in patients with unresectable pleural mesothelioma. Furthermore, this improved efficacy was transformed into a significant symptomatic benefit. These data led to the approval of the drug by the US Food and Drug Administration and recently by the European Medicines Evaluation Agency for this combination in malignant pleural mesothelioma, and consequently founded the first standard of treatment in this disease. This review reflects the development of chemotherapy in malignant pleural mesothelioma, discusses the results of the EMPHACIS trial, and outlines further developments for pemetrexed-containing regimens in malignant pleural mesothelioma.
Reck
Martin
M
Department of Thoracic Oncology, Hospital Grosshansdorf, Wöhrendamm 80, 22927 Grosshansdorf, Germany. dr.martin.reck@web.de
Gatzemeier
Ulrich
U
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D002945:Cisplatin / Q000008:administration & dosage; D002986:Clinical Trials as Topic; D017277:Drug Approval; D005060:Europe; D005971:Glutamates / Q000008:administration & dosage; D006147:Guanine / Q000008:administration & dosage / Q000031:analogs & derivatives; D006801:Humans; D008654:Mesothelioma / Q000188:drug therapy* / Q000473:pathology; D000068437:Pemetrexed; D010997:Pleural Neoplasms / Q000188:drug therapy* / Q000473:pathology; D011379:Prognosis; D013534:Survival; D014481:United States; D014486:United States Food and Drug Administration
D005971:Glutamates; D000068437:Pemetrexed; D006147:Guanine; D002945:Cisplatin