Chemotherapy Medications for Mesothelioma

For patients diagnosed with mesothelioma, chemotherapy may play a large role in treatment options, whether given by itself or as part of a comprehensive treatment plan involving surgery and/or radiation.

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Chemotherapy Medications Overview

Mesothelioma patients can receive chemotherapy by itself, or in combination with surgery, radiation, or other cancer drugs.

Chemotherapy introduces anti-cancer drugs into the bloodstream in cycles followed by periods of rest to allow the body time to recover. Each drug has a specific frequency regarding how often it has to be administered. Generally, each cycle lasts about three to four weeks.

Chemotherapy is recommended for patients with good overall health for which it would be reasonably safe to administer, and also based on the extent of the cancer.

For patients able to undergo surgery, chemotherapy may be given before or after the procedure based on factors such as mesothelioma cell type and specialist recommendation.

For patients unable to undergo surgery, chemotherapy may slow mesothelioma cell growth or shrink the tumor but in most cases, complete disappearance of these cancer cells is very unlikely.

While taking any medication during chemotherapy, it’s extremely important to keep a written list of all non-prescription (over-the-counter) and prescription medicines being taken. This list should include any dietary, mineral, or vitamin supplements or products being used.

Bring this list with you in case of emergencies, as well as to all doctor and hospital visits.

Side effects of chemotherapy will vary based on the drug used for treatments, how it’s given, what dose is applied, and overall health.

Common side effects may include:

  • Fatigue
  • Loss of appetite
  • Sore mouth and throat
  • Abdominal pain
  • Nausea or vomiting
  • Diarrhea
  • Low blood counts
  • Skin rash
  • Nervous system damage

Talk to your doctor if you or a loved one experiences these or other side effects from mesothelioma treatment. The sooner side effects are mentioned, the faster medical professionals can help deal with and potentially alleviate these symptoms.

First-Line vs Second-Line Chemotherapy Drugs

First-line therapy (also called primary treatment/therapy) is the accepted practice approved by the medical establishment as the most effective treatment for certain types of cancer.

The focus of first-line therapy is often to cure the mesothelioma if possible, which means eliminating as many cancer cells as possible. This treatment is the first assault of chemotherapy drugs on the tumor.

First-line therapies may show progress for a period of time but then stall or fail to halt the growth of cancerous cells.

Other problems with first-line therapies could include:

  • Unacceptable side effects
  • Damaged organs
  • Life-threatening symptoms
  • Limited effectiveness

Regular evaluations (physical exams and scans) will be completed to determine if the first-line therapies are working. If these treatments fail, they will be stopped and a new course of treatment will be recommended.

Some mesothelioma specialists may use second-line treatments as a first-line treatment option despite being labeled as secondary. It is worth noting that this may present problems with insurance companies when used directly as a first-line option.

These second-line treatments use drugs that have also been shown to be effective, but perhaps not as effective as first-line treatments. As more clinical trials are carried out to test and compare the effectiveness of new or existing treatments, medical standards could ultimately change.

Type of Chemotherapy Drugs for Mesothelioma

Chemotherapy drugs are anti-cancer drugs that work separately or in combination with each other and other types of cancer treatments to eliminate cancer, control cancer, or relieve its symptoms.

Clinical trials are routinely being conducted to improve upon existing treatments, test new drugs or combinations of treatments, and ways to make the drugs easier and more convenient to take (for example, taking an oral pill rather than intravenously).

Research currently being conducted in chemotherapy includes:

  • Overcoming drug resistance with other drugs
  • Finding ways to overcome drug resistance by testing combinations of drugs
  • Improving doses and schedules
  • Nanotechnology to deliver chemotherapy
  • Combining radiation therapy and chemotherapy

While on any chemotherapy drug for mesothelioma, it’s extremely important to keep all appointments with your doctor and for blood tests.

Before beginning or receiving medical treatments, tests will be ordered to make sure it is safe to proceed with treatment.

While receiving medical treatment, tests will also be ordered during and after to make sure the body is not rejecting treatment or experiencing serious side effects. Doctors may stop or delay treatment if certain side effects become present to maintain the health of the patient.

For all treatment options, make sure to speak with your doctor as survival rates vary.

Survival rates may depend on the following factors:

  • Gender and age
  • Overall health
  • Stage and type of cancer
  • Genetics and medical history

Any drug included in the chemotherapy process can interact with other medicines or herbal products. Make sure to tell your medical professionals about any medicines, herbal supplements, over the counter remedies, or vitamins you are currently taking.

Alimta

Alimta, otherwise known as pemetrexed disodium, is an FDA-approved medication that works to block the actions of substances in the body that encourage cancer cell multiplication.

While on Alimta, it’s important to keep all appointments with labs and doctors to check and maintain the body’s response to all medicines currently being used.

Several Alimta clinical studies are available if current treatment is not recommended by doctors. Before looking into clinical trials, make sure to consult with your doctor to verify you qualify.

Studies being conducted include research on discovering the different treatment effects of Alimta for use with other medications, radiation therapy, maintenance therapy, surgery, and other techniques.

Typical results of using Alimta with other medications or in tandem with other treatment options have been positive.

When comparing Alimta alone versus in use with other medicinal treatments like Cisplatin (see below), results increase greatly, and growth rates of tumors decrease significantly.

Possible side effects of Alimta may include:

  • Headaches
  • Weakness
  • Tiredness
  • Nausea
  • Vomiting
  • Dizziness
  • Confusion
  • Weight loss
  • Loss of appetite
  • Anemia
  • Constipation
  • Depression
  • Changes in mood
  • Joint or muscle pain
  • Fast heartbeat
  • Difficulty staying/falling asleep

Cisplatin

FDA-approved Cisplatin forms charged, highly reactive, platinum complexes in the body that bind to nucleophilic groups in DNA.

The reaction of Cisplatin works in cross-links (a chemical bond between chains of atoms in the body) to help stop the growth of cancerous cells or encourage the death of these cancerous cells.

Possible side effects of Cisplatin may include:

  • Fatigue and weakness
  • Loss of appetite, change in taste, mouth sores
  • Nausea, vomiting, diarrhea, or constipation
  • Low blood cell counts
  • Injury to the kidneys or liver
  • Hearing loss or ringing in the ears (tinnitus)
  • Nerve damage in the fingertips and toes (neuropathy)
  • Hair loss
  • Allergic reaction

Gemcitabine

An antimetabolite, Gemcitabine is an FDA-approved drug that is injected into the vein weekly for the length of treatment as prescribed by doctors.

It enters the body resembling a normal cell nutrient that cancer cells require to keep growing. As a look-alike, it is “ingested” by the cancer cells and interferes with their growth.

Several clinical trials are being conducted on the effects and usage of Gemcitabine alone and with other treatment options.

Possible side effects of Gemcitabine may include:

  • Flu-like symptoms
  • Fever
  • Fatigue and weakness
  • Poor appetite, mouth sores
  • Rash
  • Low blood cell counts
  • Diarrhea
  • Hair loss
  • Shortness of breath
  • Difficulty sleeping

Carboplatin

Carboplatin is a chemotherapy drug that interferes with the development of the genetic material in the DNA and cells, which stops the cancer from dividing into two new cells before causing them to die.

FDA-approved, it is given intravenously, and both the dose and schedule given will be tailored to each individual’s needs. Some treatments may be given directly into the peritoneal cavity in the abdomen.

Possible side effects of Carboplatin may include:

  • Fatigue and weakness
  • Poor appetite or taste changes
  • Mouth sores
  • Hair loss
  • Nausea and vomiting
  • Constipation or diarrhea
  • Low blood cell
  • Hearing loss
  • Allergic reaction

Bevacizumab

Bevacizumab, otherwise known as Avastin, is an FDA-approved antibody that targets and blocks the growth of blood vessels that the cancer needs to receive nutrients to grow. Bevacizumab is typically given in combination with other chemotherapy drugs.

Possible side effects of bevacizumab may include:

  • Fatigue and weakness
  • Poor appetite, weight loss, mouth sores
  • Abdominal pain, nausea or vomiting
  • Diarrhea or constipation
  • Shortness of breath
  • Low blood cell counts
  • Infection risks
  • Bleeding risks
  • High blood pressure
  • Protein spilling into urine
  • Hair loss
  • Muscle aches and pains

Onconase

Undergoing clinical trial testing, Onconase is relatively new, and studies are working to determine its level of effectiveness in treating mesothelioma.

Onconase inhibits cellular growth, speeding up the breakdown of ribonucleic acid (RNA), and initiating death in cancerous cells. It also enhances the anti-cancer effect of traditional treatments for mesothelioma chemotherapy.

Though Onconase is one of many new chemotherapy drug options in clinical testing, initial clinical studies may suggest it could be a better treatment option than traditional chemotherapy drugs. This is because it produces few of the side effects commonly experienced during chemotherapy.

Onconase currently holds an orphan drug status by the FDA, which means that it is intended to treat diseases so rare that pharmaceutical companies are not likely to develop them under unusual market conditions or limited potential for profitability.

Navelbine

Mainly used in clinical trials to date, Navelbine (Vinorelbine) is an FDA-approved anti-cancer drug that works by interfering with genes and stops the cells from reproducing.

Possible side effects of Navelbine may include:

  • Low blood cell counts
  • Nausea or vomiting
  • Constipation or diarrhea
  • Muscle weakness
  • Hair loss
  • Nerve damage in toes and fingers

Several clinical trials are being conducted on the effects and usage of Navelbine alone and with other treatment options.

Current Drugs/Combinations Being Tested in Clinical Trials

The drugs listed above are in clinical trials by themselves, in combination with other drugs, or in combination with other therapies and treatments.

Immunotherapy, a newer class of cancer treatments that helps the body’s immune system fight cancer smarter, is also being actively studied in patients with mesothelioma.

These treatments, including nivolumab (Opdivo), ipilimumab (Yervoy), and pembrolizumab (Keytruda), have shown promising benefits when given alone or in combination to patients with mesothelioma.

They continue to be evaluated in clinical trials but are currently recommended for patients whose cancer is no longer responding to chemotherapy.

Contact our Victim Advocates today for more information on getting your chemotherapy medication costs covered through legal compensation options for mesothelioma patients.

Mesothelioma Support Team
Reviewed by:Dr. Assuntina Sacco

Board-Certified Oncologist

  • Fact-Checked
  • Editor

Assuntina Sacco, MD is an Associate Professor of Internal Medicine at the University of California, San Diego (UCSD) Moores Cancer Center, where she also serves as the Medical Director of Infusion Services. She is a board-certified medical oncologist trained to treat all solid tumor types, with the use of chemotherapy, immunotherapy, targeted therapy, and clinical trials.

Dr. Assuntina Sacco is an independently paid medical reviewer.

Stephanie KiddWritten by:

Editor-in-Chief

Stephanie Kidd grew up in a family of civil servants, blue-collar workers, and medical caregivers. Upon graduating Summa Cum Laude from Stetson University, she began her career specializing in worker safety regulations and communications. Now, a proud member of the American Medical Writers Association (AMWA) and Editor-in-Chief of the Mesothelioma Justice Network, Stephanie serves as a voice for mesothelioma victims and their families.

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