Eli Lilly and Company markets pemetrexed under the brand name Alimta. It's the most effective chemotherapy drug for mesothelioma. Doctors often combine Alimta with platinum-based drugs such as cisplatin and carboplatin to increase its effectiveness.
Diagnosed with mesothelioma? Get a free guide to learn about the latest treatment options.
Access information on top mesothelioma treatments.
Alimta (pemetrexed) is a chemotherapy drug for non-squamous non-small cell lung and mesothelioma cancer. Doctors have successfully prescribed it to non-squamous NSCLC and mesothelioma patients for decades. Since the U.S. Food and Drug Administration approved it to treat cancer, few chemotherapy drugs have had as much of an effect as Alimta.
For many patients, Alimta stands out as having the most promise in prolonging mesothelioma life expectancy. It also improves quality of life, reducing breathing difficulty and chest pain. This medication blocks DNA replication and cell division, killing mesothelioma cells.
Alimta Information
Doctors can use Alimta alone or in combination with other drugs to treat mesothelioma. Alimta is an antimetabolite drug that disrupts the normal biological breakdown of chemicals used during metabolism.
Patients who are pregnant shouldn’t take Alimta because it could harm the unborn baby. If you’re considering Alimta, tell your doctor if you have kidney or liver disease, a weak immune system or excess fluid in your chest cavity.
How Does Alimta Treat Mesothelioma?
Alimta prevents cancer cells from rapidly dividing. It also blocks the production of folate and stops the division and replication of mesothelioma cells, causing them to die instead of grow. Because it blocks folate, Alimta is considered an antifolate antimetabolite.
The recommended dosage for Alimta is 500 mg/m2, administered through a port or an intravenous line over 10 minutes. The guidelines recommend 21 days, or a cycle, between each IV infusion.
Kevin Hession
Verified Asbestos.com Survivor
Mesothelioma Survivor Describes His Success With Chemotherapy
Pleural mesothelioma survivor Kevin Hession says he actually gained weight following his chemotherapy treatments. “I’ve never had a bad experience with chemotherapy,” Kevin said. “My worst case on a scale of 1 to 10 has probably been a 3.” His treatments have gone so well he was offered an option to take what he calls a “chemo holiday,” allowing him to skip a round.
Alimta Treatment for Pleural Mesothelioma
Doctors often combine Alimta with cisplatin to improve survival in pleural mesothelioma patients. Pleural mesothelioma affects the lining of the lungs and chest wall. Alimta can help slow growth and kill cells that contribute to the effects of cancer, such as chest pain, shortness of breath and cough.
Doctors often pair platinum drugs with pemetrexed, known by its brand name Alimta. Pemetrexed is thought to be the most active mesothelioma chemotherapy drug. Combining pemetrexed with platinum drugs showed over 20% improvement in treatment response with more growth control and survival time.
This is the only FDA-approved chemotherapy regimen for mesothelioma. Alimta and cisplatin are the most commonly prescribed drugs for first-line pleural mesothelioma chemotherapy. They help mesothelioma patients live for around one year. Without them, most patients survive an average of 4 months.
Alimta Treatment for Peritoneal Mesothelioma
Alimta isn’t a standard therapy for peritoneal mesothelioma. It may be part of a multimodal approach that includes cytoreductive surgery and hyperthermic intraperitoneal chemotherapy. Although Alimta is only approved for pleural mesothelioma, doctors may use it for some patients based on clinical evidence.
Multiple clinical trials are recruiting patients with peritoneal mesothelioma to test the effectiveness of Alimta in certain situations, such as after surgeries like HIPEC. These studies may lead to more practical uses of Alimta for peritoneal mesothelioma that can provide improved survival and symptom relief.
The chemotherapy did what it was intended to do and it killed the cancer. Since the HIPEC procedure, I have not had any cancer recurrences. I’m a 15-year and counting survivor.
Alimta for Asbestos-Related Lung Cancer
Doctors prescribe Alimta for patients with NSCLC after prior chemotherapy. The drug also comes in an injectable form, which can treat patients with a new diagnosis of locally advanced or metastatic non-squamous NSCLC.
The first phase I study of Alimta for mesothelioma was completed in 1999. It combined Alimta and cisplatin for mesothelioma and proved the effectiveness of these drugs against this cancer.
The side effects of Alimta are usually mild to moderate for most patients. Some patients may experience extreme side effects. A doctor should be informed immediately if a reaction becomes a serious problem.
Patients with certain conditions should consult their doctor about the risks and benefits of taking Alimta. Anyone with kidney disease, liver disease, a weak immune system or excess fluid in the space around their lungs, liver or other internal organs should take precautions.
Common Side Effects of Alimta as Single Agent
Anorexia
Fatigue
Nausea
Mesothelioma patients should avoid being near people with colds, the flu or other signs of illness. If they develop signs of infection, they should contact their doctor immediately.
Tell your doctor before receiving Alimta if you’re taking a non-steroidal anti-inflammatory drug to avoid a drug interaction. NSAIDs include ibuprofen, naproxen, indomethacin and ketoprofen.
Side Effects of Alimta With Cisplatin
In addition to Alimta’s side effects, patients may experience additional side effects when combined with cisplatin. More than 20% of patients taking Alimta in combination with cisplatin report experiencing the following: Anemia (deficiency of red blood cells), constipation, low blood platelet count (thrombocytopenia), low or reduced white blood cell count, sores and swelling in the mouth and throat and vomiting.
Diagram shows the most common side effects of using Alimta with cisplatin.
Alimta changed the landscape of mesothelioma treatment in the early 2000s. Before its FDA approval, mesothelioma patients had few options to extend their survival.
Researchers continue to test Alimta in combination with new drugs. Their goal is to find the most effective ways to use it to improve the lives of people with mesothelioma.
Alimta Research
Clinical trials are researching more effective drug combinations to treat mesothelioma. Alimta is used as the baseline chemotherapy drug for these combinations.
The National Comprehensive Cancer Network changed its first-line treatment recommendation for inoperable pleural mesothelioma in 2016. NCCN added the monoclonal antibody Avastin (bevacizumab) to the Alimta and cisplatin combination. Avastin is an anti-angiogenesis drug that blocks mesothelioma from spreading.
A 2023 phase II clinical trial is testing Alimta in pleural mesothelioma patients before treating them with surgery and radiation.
In a study of Tumor Treating Fields with Alimta and cisplatin or carboplatin, a median survival of 18.2 months was demonstrated. This study led to the approval of TTFields for treatment of mesothelioma.
In a trial studying the combination of cisplatin and Alimta with the immune checkpoint inhibitor Imfinzi (durvalumab), 57% of patients had no mesothelioma progression at 6 months. This combination is now being studied in a large phase III trial.
In 2004, the FDA approved Alimta with cisplatin for treating malignant pleural mesothelioma. The results of Dr. Nicholas J. Vogelzang’s phase III clinical trial led to its approval. This study inspired other mesothelioma specialists like Dr. Hedy Kindler to study Alimta further.
The sources on all content featured in The Mesothelioma Center at Asbestos.com include medical and scientific studies, peer-reviewed studies and other research documents from reputable organizations.
ClinicalTrials.gov. (2016, January 15). Methoxyamine, Cisplatin, and Pemetrexed Disodium in Treating Patients With Advanced Solid Tumors or Mesothelioma That Cannot Be Removed by Surgery or Mesothelioma That Is Refractory to Cisplatin and Pemetrexed. Retrieved from https://clinicaltrials.gov/ct2/show/NCT02535312
Fujimoto, E., et al. (2017). First-line chemotherapy with pemetrexed plus cisplatin for malignant peritoneal mesothelioma. Expert Rev Anticancer Ther; 17(9):865-872. doi: 10.1080/14737140.2017.1340157
Vogelzang, N.J. (2003). Phase III study of pemetrexed in combination with cisplatin versus cisplatin alone in patients with malignant pleural mesothelioma. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/12860938
Current Version
October 21, 2024
Written By
Karen Selby, RN
Edited By
Walter Pacheco
Medically Reviewed By
Arkadiusz Z. Dudek
Recommended Reading
Tell us what you think
Did this article help you?
How did this article help you?
What about this article isn’t helpful for you?
Did this article help you?
Thank you for your feedback. Would you like to speak with a Patient Advocate?
Your web browser is no longer supported by Microsoft. Update your browser for more security, speed and compatibility.
If you are looking for mesothelioma support, please contact our Patient Advocates at (855) 404-4592
Who Am I Calling?
Calling this number connects you with a Patient Advocate at The Mesothelioma Center, the nation's most trusted mesothelioma resource.
Our Patient Advocates can help guide you or your loved one through the steps to take after a mesothelioma diagnosis. Our team has a combined experience of more than 30 years in assisting cancer patients, and includes a medical doctor, an oncology registered nurse and a U.S. Navy veteran.
Our fact-checking process begins with a thorough review of all sources to ensure they are high quality. Then we cross-check the facts with original medical or scientific reports published by those sources, or we validate the facts with reputable news organizations, medical and scientific experts and other health experts. Each page includes all sources for full transparency.
Reviewed
Asbestos.com is the nation’s most trusted mesothelioma resource
The Mesothelioma Center at Asbestos.com has provided patients and their loved ones the most updated and reliable information on mesothelioma and asbestos exposure since 2006.
Our team of Patient Advocates includes a medical doctor, a registered nurse, health services administrators, veterans, VA-accredited Claims Agents, an oncology patient navigator and hospice care expert. Their combined expertise means we help any mesothelioma patient or loved one through every step of their cancer journey.
More than 30 contributors, including mesothelioma doctors, survivors, health care professionals and other experts, have peer-reviewed our website and written unique research-driven articles to ensure you get the highest-quality medical and health information.
About The Mesothelioma Center at Asbestos.com
Assisting mesothelioma patients and their loved ones since 2006.
Helps more than 50% of mesothelioma patients diagnosed annually in the U.S.
A+ rating from the Better Business Bureau.
5-star reviewed mesothelioma and support organization.
My family has only the highest compliment for the assistance and support that we received from The Mesothelioma Center. This is a staff of compassionate and knowledgeable individuals who respect what your family is experiencing and who go the extra mile to make an unfortunate diagnosis less stressful. Information and assistance were provided by The Mesothelioma Center at no cost to our family.
A medical doctor who specializes in mesothelioma or cancer treatment reviewed the content on this page to ensure it meets current medical standards and accuracy.
Please read our editorial guidelines to learn more about our content creation and review process.
Dr. Arkadiusz Z. Dudek is a medical oncologist at Regions Hospital Cancer Care Center in Minnesota treating several cancers, including pleural mesothelioma.
California Consumer Privacy Act (CCPA) Inquiries
Mesothelioma Center - Vital Services for Cancer Patients & Families doesn’t believe in selling customer information. However, as required by the new California Consumer Privacy Act (CCPA), you may record your preference to view or remove your personal information by completing the form below.
