Alimta Chemotherapy for Mesothelioma
Alimta belongs to the class of chemotherapy drugs called folate antimetabolites. It mimics natural substances present in human cells. When these substances become part of the cell’s metabolism, the cells cannot divide as they would normally.
Drugs known as antimetabolites interfere with the cell’s metabolism at particular phases and they are more specifically classified according to the substances with which they interfere.
Alimta is an antifolate, which means it inhibits the cell’s metabolic functions that depend upon folate and that are necessary in order for the cell to reproduce itself. Alimta works to prevent three enzymes, thymidylate synthase (TS), dihydrofolate reductase (DHFR), and glycinamide ribonucleotide formyl transferase (GARFT), which are required for the development of two nucleotides known as purine and pyrimidine. Nucleotides are molecules that form the structural units of RNA and DNA. If purine and pyrimidine aren’t made, neither is RNA and DNA, and this stops the survival of existing cancer cells and the growth of new ones.
Specific Dose Requirements for Alimta Mesothelioma Chemotherapy
When Alimta is given for the treatment of malignant pleural mesothelioma, it is administered in a dose of 500 mg/m2, or 500 milligrams per square meter of body surface area (BSA). There are several different formulas to measure BSA, but the one that is most often used is Mosteller’s, published in The New England Journal of Medicine in 1987. However, in general practice, an adult’s BSA is considered to be 1.7 m2.
The drug is given in combination with cisplatin in the following method:
Day 1 of the 21-day mesothelioma chemotherapy cycle, 500mg/m2 of Alimta administered intravenously. Thirty minutes later, 75 mg/m2 of cisplatin administered intravenously.
Mesothelioma chemotherapy with Alimta Side Effects
Chemotherapy patients on a regimen of cisplatin and Alimta may experience the following side effects:
- Low white and red blood cell count
- Low platelet level
- Sore throat
- Mouth or lip sores
Special Instructions for the Use of Alimta for Mesothelioma Patients
The drug’s manufacturer, Eli Lilly and Company, makes the following recommendations before beginning treatment:
- Patients treated with ALIMTA must be instructed to take folic acid and vitamin B12 as a prophylactic (preventative) measure to reduce treatment-related hematologic (blood) and gastrointestinal toxicity
- Patients should be adequately informed of the risk of low blood cell counts and instructed to immediately contact their physician should any sign of infection develop including fever. Patients should also contact their physician if bleeding or symptoms of anemia occur.
- Patients should be instructed to contact their physician if persistent vomiting, diarrhea, or signs of dehydration appear.
- Patients should be instructed to inform the physician if they are taking any concomitant prescription (a prescription taken at the same time) or over-the-counter medications including those for pain or inflammation such as non-steroidal anti-inflammatory drugs.