Researchers from the German MesoNet study published new findings on the combination of pemetrexed and platinum as a treatment for pleural mesothelioma, results that could shed new light on its use in battling the deadly cancer.
As part of a retrospective, multicenter study examining mesothelioma patients from 12 participating cancer centers across Germany, researchers found promising data for pemetrexed and platinum as a second-line treatment after a first-line treatment of nivolumab and ipilimumab.
The researchers stated that its findings supported pemetrexed and platinum as an effective second-line option, and provided further information on how to better use it.
What Is Pemetrexed?
Pemetrexed is the generic name for Alimta, which is one of the five common chemotherapy drugs used for the treatment of mesothelioma. The U.S. Food and Drug Administration (FDA) approved pemetrexed for malignant mesothelioma in 2004.
Pemetrexed is a type of medication called an antifolate antineoplastic chemotherapy agent. This means that it fights cancer by interfering with the body’s use of folate to make DNA and RNA inside cancer cells, which stops them from growing and dividing.
However, pemetrexed can often have serious side effects, as it can also affect healthy cells that use folate for normal growth and repair. For that reason, it is often prescribed along other supplements that can help ease the burden of these effects.
How Do Pemetrexed and Platinum Treat Mesothelioma?
Pemetrexed is approved in combination with cisplatin, which is a platinum-based chemotherapy that attacks DNA inside the cancer cells themselves, ultimately killing the cancer cells.
Many mesothelioma patients are unable to tolerate cisplatin. In these cases, cisplatin is often replaced by another platinum-based chemotherapy agent called carboplatin, which attacks cancer cells in a similar manner but is generally easier on a patient’s kidneys and nervous system.
Pemetrexed and one of these platinum agents is often recommended as a second-line treatment for patients following nivolumab and ipilimumab as a first-line treatment. However, as the MesoNet researchers noted, most of the data supporting pemetrexed and platinum as an effective treatment is based on its use as a first-line treatment, not in this context. This made further examining its effect as a second-line treatment a priority.
What Could These Results Mean For Mesothelioma Treatment?
Of the 135 patients in the MesoNet study that were treated with nivolumab and ipilimumab as their first-line treatment, 41 received pemetrexed and platinum as a second-line treatment. Of these, patients showed a median overall survival of 11.5 months and 5.8 months of progression-free survival.
These numbers, along with the 72% disease control rate observed and the “meaningful clinical activity” seen in this cohort of patients, suggested to the researchers that pemetrexed and platinum are an effective second-line option for pleural mesothelioma and should continue to be emphasized in these situations.
However, the high attrition rate of the treatment – only 16% of the overall sample progressed to a third-line treatment – further underlined the need for careful patient selection, and the need for medical providers to be more proactive in initiating second-line treatment earlier.
Sources & Author
- Outcomes of Platinum Plus Pemetrexed and Treatment Patterns Following First-Line Nivolumab and Ipilimumab in Pleural Mesothelioma: Real-World Results From the German MesoNet Study. Clin Lung Cancer. Retrieved from https://pubmed.ncbi.nlm.nih.gov/42372417/. Accessed 07/07/2026.
