For patients diagnosed with mesothelioma, chemotherapy may play a large role in treatment options, whether given by itself or in tandem with surgery or other drugs.
Chemotherapy Medications Overview
Chemotherapy introduces anti-cancer drugs into the bloodstream in cycles followed by periods of rest to allow the body time to recover. These cycle times last about three to four weeks and are only recommended for patients with good overall health.
Mesothelioma patients can receive chemotherapy by itself, or in combination with surgery or other drugs. For patients able to undergo surgery, chemotherapy can be given before or after the procedure based factors like mesothelioma cell type and specialist recommendation. For patients unable to undergo surgery, chemotherapy may slow mesothelioma cell growth or shrink the tumor but in all cases, complete removal of these 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:
- Loss of appetite
- Skin rash
- Sore mouth and throat
- Low blood cell counts
- Abdominal pain
- Nervous system damage
- Nausea and vomiting
Talk to your doctor if you or a loved one experience these side effects from chemotherapy treatments. The sooner these 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 for treatment of certain types of cancer. The focus of first-line therapy is to cure the mesothelioma as much as possible, which means eliminating as many cancer cells as possible for mesothelioma patients. This treatment is the first assault of chemotherapy drugs on the tumor.
First-line therapies may show progress for a period 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 efficacy
When first-line therapies fail during regular evaluations, treatment is adjusted, and after a break, a new course of treatment and drugs will be adopted. Some 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 secondary treatments use new drugs that have already proved effective in treatment purposes. These newer drugs will eventually be submitted to the FDA for approval after years of experience and use in patients with generally favorable outcomes. This could move the second-line option into a first-line treatment option, provide favorable results in patients, and less potential complications with insurance companies.
As more studies and clinical trials are carried out, and research is discovered, these medical standards may 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. Various studies and clinical trials are always being conducted to improve treatments, combination treatments, and 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
- 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 the laboratory and your doctor. Before beginning treatment or receiving the medicinal treatments below, tests will be ordered to check your response and viability of accepting certain courses of treatment. While receiving medicinal 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 drug and treatment options, make sure to speak with your doctor as survival rates vary based on factors that may include:
- Gender and age
- Overall health
- Stage and subtype of the 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, 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 produced positive results in preclinical testing. 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.
Common side effects of Alimta may include:
- Headaches, weakness, tiredness
- Nausea, vomiting, dizziness, or confusion
- Weight loss or loss of appetite
- Pale skin
- Depression or changes in mood
- Joint or muscle pain
- Fast heartbeat
- Difficulty staying or falling asleep
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.
Cisplatin may cause:
- Serious kidney problems
- Serious hearing problems
- Severe allergic reactions
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.
Common side effects of Gemcitabine may include:
- Feeling or being sick
- Increased risk of contracting an infection
- Bruising, nosebleeds, or bleeding gums
- Breathlessness, wheezing, and unusual paleness
- Flu-like symptoms
- Drowsiness, fatigue, and weakness during and after treatments
- Liver changes
- Hair thinning or skin rash
- Swelling of the feet, hands, and/or face
- Blood or protein in the urine
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.
Common side effects of Carboplatin may include:
- Low blood counts of platelets, white blood cells, and red blood cells
- Blood test abnormalities and magnesium levels
- Hair loss
- Taste changes
- Nausea and vomiting (commonly within 24 hours of treatment)
Some of the less common side effects that occur in 10-29% of patients can include:
- Mouth sores
- Constipation and diarrhea
- Abdominal pain
- A burning sensation at the site of injection
- Allergic reaction
- Hearing loss
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 cellular death in cancerous cells. It also enhances the anti-cancer effect of traditional treatments for mesothelioma chemotherapy. It is possible that Onconase could also be used to assist certain HIV medications and treat various types of cardiovascular disease.
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 the 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.
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. Several clinical trials are being conducted on the effects and usage of Navelbine alone and with other treatment options.
Common side effects of Navelbine may include:
- Low blood counts of platelets, white blood cells, and red blood cells
- Muscle weakness
- Vomiting or nausea
Less common side effects that occur in 10-29% of patients can include:
- Hair loss
- Low platelet counts (increases risk of bleeding)
- Numbness in toes and fingers
- Pain at the site of injection
Current Drugs/Combinations Being Tested in Clinical Trials
All of the drugs listed above are in clinical trials by themselves, in combination with another drug listed, in combination with a different drug or drugs, or in combination with other therapies and treatments.
As drug combination usage has gained notoriety within the pharmaceutical industry, an increase in clinical testing of new drugs in combination with already marketed chemotherapy drugs has been a regular trend. This emphasized focus on drug combinations (occurring as early as phase 1 of clinical trials) has resulted in the overall increased efficacy of new-to-market cancer therapies.
Contact our Victim Advocates today for more information on getting your chemotherapy medication costs covered through legal compensation options for mesothelioma patients.