Written By: Devin Golden

Alimta and Cisplatin for Mesothelioma

Alimta (pemetrexed) and cisplatin are considered the standard combination of chemotherapy drugs to treat mesothelioma. They can significantly affect a patient’s life expectancy.

Karen Ritter, RN BSN

Medically Reviewed By

Karen Ritter, RN BSN

Registered Nurse

Karen Ritter, RN BSN

Medically Reviewed By

Karen Ritter, RN BSN

Registered Nurse


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Important Facts About Alimta and Cisplatin for Mesothelioma

  • The U.S. Food and Drug Administration approved Alimta and cisplatin for malignant mesothelioma in 2004. It was the first treatment approved for the rare cancer.
  • Alimta is the brand name for pemetrexed. Cisplatin is the most common platinum-based chemotherapy drug.
  • The combination of pemetrexed and cisplatin has an average survival of around 12 months, with variances depending on the patient’s demographics (gender, age, stage of cancer, etc.).

Survival From Alimta and Cisplatin for Mesothelioma

When clinical studies of Alimta were successful for other cancers, researchers began experimenting combinations with other successful chemotherapy drugs. The most notable drug combination was Alimta with cisplatin, and it made chemotherapy even more effective for treating mesothelioma.

A study in 2008 compared the combination versus just one chemotherapy drug. There was a four-month survival benefit for cisplatin-Alimta together. An earlier study, in 2004, showed a three-month survival improvement.

The combination of cisplatin and pemetrexed has a median survival in many studies of 12 months. One study had a median survival of 13.4 months. The survival may improve in some studies due to factors like patient selection and stage of disease.

Alimta (Pemetrexed) for Mesothelioma

Alimta is the brand name for the generic chemotherapy drug pemetrexed. This antifolate drug interferes with enzymes that are essential for the production and growth of mesothelioma cells.

Cisplatin (Platinol) for Mesothelioma

Cisplatin is the generic name for the platinum-based chemotherapy drug Platinol. Cisplatin was first developed to treat testicular, bladder and ovarian cancer. Although cisplatin has been around for decades, it was approved for use alongside Alimta in 2004.

Cisplatin is also used for heated intraoperative chemotherapy in patients with peritoneal mesothelioma. After a patient has a cytoreductive surgery, doctors apply heated cisplatin directly into the abdomen to kill remaining cancer cells. This is called HIPEC. Doxorubicin and carboplatin are other chemotherapy medications used during HIPEC.

Dosing of Alimta and Cisplatin

Dosing is different for Alimta and cisplatin. Doctors usually give 500 mg of Alimta intravenously. Cisplatin is usually administered intravenously at 75 mg per cycle. These dosage amounts are recommended by the National Comprehensive Cancer Network.

Mesothelioma patients receive Alimta and cisplatin once every three weeks, which is considered a cycle. Most specialists aim for at least six cycles of the chemotherapy combination. Some doctors may go up to 12 cycles if the treatment is effective and side effects are manageable. It is up to the mesothelioma specialist to determine the number of cycles a patient receives.

Side Effects of Alimta and Cisplatin

All chemotherapy drugs have side effects. Blood tests are required at every cycle to make sure patients maintain a healthy blood cell count. Since these drugs are designed to attack mesothelioma cells, healthy cells are also killed, 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 may recommend patients take vitamin supplements. Examples include folic acid and B12.

Cisplatin also causes side effects. If they become too strenuous or difficult to manage, doctors may recommend substituting cisplatin with carboplatin. This chemotherapy medication can pair with Alimta for mesothelioma.

How to Start Alimta and Cisplatin for Mesothelioma

The combination of Alimta and cisplatin has proven to be beneficial for many mesothelioma patients. There are three steps to follow if you want to learn how to start Alimta and cisplatin for mesothelioma:

  1. Research the survival statistics and side effects of each drug. Cisplatin and Alimta are best used together for mesothelioma, improving survival. You can compare the survival rates of these medications with other therapies and also consider the side effects of chemotherapy.
  2. Look up nearby cancer centers that treat mesothelioma. Some may be within driving distance of your residence and offer state-of-the-art treatment.
  3. Contact a patient advocate for assistance connecting with a cancer center. These experts will help you connect with a specialist to begin chemotherapy treatment, or another treatment for your unique case.

Sources & Author

  1. Pemetrexed Plus Cisplatin or Pemetrexed Plus Carboplatin for Chemonaïve Patients with Malignant Pleural Mesothelioma: Results of the International Expanded Access Program. Journal of Thoracic Oncology. Retrieved from: https://www.sciencedirect.com/science/article/pii/S1556086415333499. Accessed: 05/25/2021.
  2. Review of pemetrexed in combination with cisplatin for the treatment of malignant pleural mesothelioma. Therapeutics and Clinical Risk Management. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2503655/. Accessed: 05/25/2021.
  3. Phase III Study of Pemetrexed in Combination With Cisplatin Versus Cisplatin Alone in Patients With Malignant Pleural Mesothelioma. American Society of Clinical Oncology Journal. Retrieved from: https://ascopubs.org/doi/10.1200/JCO.2003.11.136. Accessed: 05/25/2021.
  4. Chemotherapy for intraperitoneal use: a review of hyperthermic intraperitoneal chemotherapy and early post-operative intraperitoneal chemotherapy. Journal of Gastrointestinal Oncology. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4754301/. Accessed: 05/25/2021.
  5. Mesothelioma Treatment Regimens. Cancer Therapy Advisor. Retrieved from: https://www.cancertherapyadvisor.com/home/cancer-topics/lung-cancer/lung-cancer-treatment-regimens-landing-page/mesothelioma-treatment-regimens/. Accessed: 05/25/2021.
Devin Golden

About the Writer, Devin Golden

Devin Golden is the senior content writer for Mesothelioma Guide. He produces mesothelioma-related content on various mediums, including the Mesothelioma Guide website and social media channels. Devin's objective is to translate complex information regarding mesothelioma into informative, easily absorbable content to help patients and their loved ones.