Considered the standard combination of chemotherapy drugs to treat mesothelioma, Alimta and cisplatin can have a significant effect on a patient’s life expectancy.

Combining Drugs to Improve Survival

When clinical studies of Alimta were successful, researchers didn’t waste time experimenting with combining the drug with other successful chemotherapy drugs. The most notable drug combination was with cisplatin, and it made chemotherapy even more effective for treating mesothelioma. The result was a 3 month survival benefit for patients.

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    Increased Survival Benefit

    The most obvious benefit of combining Alimta and cisplatin is that it extends survival times. Several studies have shown that the combination is significantly more effective than cisplatin alone.

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    First-Line, Second-Line and Maintenance

    Alimta and cisplatin are applied in a variety of ways. For example, while they are both used as first-line chemotherapy, Alimta is usually used by itself as a form of maintenance treatment after the first-line is complete. Alimta and cisplatin are also used as second-line treatment.

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    Ongoing Trials

    There are several clinical trials studying the effects of using Alimta and cisplatin separately and together. Many trials have also studied the benefits of Alimta and cisplatin administered following surgery and radiation therapy.

Alimta (pemetrexed)

Most commonly referred to by the brand name, “Alimta,” pemetrexed is one of the most effective chemotherapy drugs for mesothelioma. This antifolate drug interferes with enzymes that are essential for the production and growth of mesothelioma cells.

Alimta was approved by the Food and Drug Administration relatively recently in 2004. Systemic chemotherapy treatment has always been particularly difficult in the treatment of mesothelioma. The inception of Alimta was a turning point for the success of chemotherapy for mesothelioma patients.

The specific issue with developing effective chemotherapy treatments for a rare cancer, such as mesothelioma, is that there is an exceedingly small group of patients to test the chemotherapy methods on in a clinical setting. Alimta, however, was revolutionary in that it was developed with mesothelioma patients in mind.

Cisplatin (Platinol)

cisplatinCisplatin is the generic name for the platinum-based chemotherapy drug that has been approved by the FDA since before 1984. (The FDA doesn’t have records of the exact dates of drugs approved prior to 1984.) Cisplatin was first developed to treat testicular, bladder, and ovarian cancer. Although cisplatin has been around for a while, it is only recently that the drug has been used in conjunction with Alimta.

Cisplatin is also commonly used for heated intraoperative chemotherapy in patients with peritoneal mesothelioma. In this scenario, after a patient has a cytoreductive surgery, doctors apply heated cisplatin directly to the abdomen to kill remaining cancer cells.


Patients receiving cycles of Alimta and cisplatin go to the hospital every 3 weeks to have the drugs administered. It only takes about 10 minutes to administer a dose of Alimta by means of an IV. Cisplatin, however, is administered by means of a drip over a 2 hour period.

It is up to the mesothelioma specialist to determine how many cycles of Alimta and cisplatin a patient receives. However, cycles may be discontinued at any point if side effects become serious. How Alimta and cisplatin are used depends on whether patients are receiving first-line, second-line, or maintenance treatment which are explained below.

  • Maintenance Chemotherapy
    First-Line Therapy
    Alimta and cisplatin are used for first-line chemotherapy. First-line therapy consists of the first cycles of chemotherapy a patient initially receives to stop the growth of their cancer. Each drug may be used together or separately as first-line therapy, though the combination of the two drugs together is more effective.
  • Second-Line Chemotherapy
    Second-Line Therapy
    In the case that first-line chemotherapy wasn’t effective, a second line of chemotherapy is used in the hope that a patient will respond well to the new treatment. Alimta is often used as second-line therapy for patients who didn’t respond to cisplatin alone as first-line therapy.
  • First-Line Chemotherapy
    Maintenance Therapy
    After all the cycles of Alimta and cisplatin are complete, maintenance therapy is used to keep mesothelioma cells at bay and prolong remission. Although research is ongoing to find the most effective maintenance treatment, Alimta is often administered without cisplatin at this point in a patient’s treatment.

Side Effects

All chemotherapy drugs have side effects and Alimta and cisplatin are no exception. Blood tests are required at every cycle to make sure patients maintain a healthy blood cell count. Because these drugs are designed to attack mesothelioma cells, other healthy cells are also killed in the process, lowering the patient’s immune system and increasing their potential for getting sick or developing an infection.

In order to stem the specific side effects of Alimta, physicians instruct patients to take vitamin supplements including folic acid and B12. These vitamins are taken a week prior to the first cycle of chemotherapy and are taken continually until 3 weeks following the last cycle of chemotherapy.

These vitamins are essential to arm patients against the side effects of Alimta. While a patient is going through chemotherapy cycles, they are required to have regular blood tests to make sure their blood cell count stays in a safe range.

Finding the Right Chemotherapy Drugs

Although the combination of Alimta and cisplatin has proven to be beneficial for many mesothelioma patients, they may not be the right drugs for you. For instance, some patients are sensitive to platinum-based chemotherapy drugs like cisplatin and may require a different combination. For some patients, chemotherapy may not be a viable option at all.

Factors that may determine which chemotherapy drugs offer you the greatest benefit include:

  • The location of the tumor
  • The stage of the disease
  • Overall health of patient

Only a mesothelioma specialist can tell you which treatment is best for you based on your specific diagnosis. Use our free Doctor Match program to find a qualified specialist near you.