title: The value of pemetrexed for the treatment of malignant pleural mesothelioma: a comprehensive review.
abstract: This review aims to provide insight into treatment of malignant pleural mesothelioma (MPM) considering effects on survival, quality of life (QoL) and costs, in order to determine the value of pemetrexed in MPM treatment. Cisplatin in combination with pemetrexed or raltitrexed increased survival in MPM, whereas vinorelbine and gemcitabine have led to good response rates. None of these appear to have any detrimental effect with respect to symptoms and global QoL. The cost-effectiveness of pemetrexed-cisplatin was found to be acceptable in advanced MPM compared with cisplatin, but raltitrexed-cisplatin was found to be a more cost-effective treatment option. This may also apply for gemcitabine and vinorelbine, since in contrast to pemetrexed, both agents can be obtained from generic manufacturers. As yet platinum-doublet therapy is the most effective palliative treatment of MPM. To provide a more cost-effective treatment approach for advanced MPM, further research should include randomized controlled trials comparing the recommended pemetrexed-cisplatin directly with platinum doublets with raltitrexed, gemcitabine, or vinorelbine.
authors.affiliation: M.Sc., VU University Medical Center, Department of Clinical Pharmacology and Pharmacy, De Boelelaan 1117, 1081 HV Amsterdam, the Netherlands. c.boons@vumc.nl.
authors.forename: Christel C L M
authors.initials: CC
authors.lastname: Boons
authors.forename: Maurits W
authors.initials: MW
authors.lastname: VAN Tulder
authors.forename: Jacobus A
authors.initials: JA
authors.lastname: Burgers
authors.forename: Jan Jacob
authors.initials: JJ
authors.lastname: Beckeringh
authors.forename: Cordula
authors.initials: C
authors.lastname: Wagner
authors.forename: Jacqueline G
authors.initials: JG
authors.lastname: Hugtenburg
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use*; D005971:Glutamates / Q000627:therapeutic use*; D006147:Guanine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006801:Humans; D008654:Mesothelioma / Q000188:drug therapy* / Q000503:physiopathology; D000068437:Pemetrexed; D010997:Pleural Neoplasms / Q000188:drug therapy* / Q000503:physiopathology; D011788:Quality of Life
chemical_list: D000970:Antineoplastic Agents; D005971:Glutamates; D000068437:Pemetrexed; D006147:Guanine
keywords: Mesothelioma; Premetrexed; chemotherapy; health economics; quality of life; review; treatment outcome