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Common Drugs

Most Common Chemotherapy Drugs for Mesothelioma

In spite of all the medical advancements in the fight against mesothelioma, chemotherapy involving drugs is still one of the most common treatments for asbestos related cancer and diseases. It’s usually combined with selected surgeries and may be followed (or preceded) by radiotherapy (dosing with targeted or untargeted radiation). 

There are a number of drugs available for mesothelioma doctors to choose from when treating patients and most use multiple drugs in cocktail form to achieve the best results possible. Some of the most common mesothelioma chemotherapy drugs include:

Cisplatin

Cisplatin or cisplatin-based therapy is one of the most common forms of chemotherapy used to treat mesothelioma. Cisplatin is a platinum-based drug approved by the FDA to treat various forms of cancers including ovarian and lung cancer. It works by interfering with the DNA of cancer cells, thus disrupting their reproductive cycles and making it difficult for them to grow or spread. 

Cisplatin is manufactured by Bristol Myers Squibb and has been in use since 1978.
Cisplatin, like most chemotherapy drugs, is administered intravenously. Being one of the older, more toxic chemotherapy drugs, the side effects of cisplatin are some of the most pronounced. They include:
  • Kidney damage
  • Nausea
  • Increased risk of and inability to fight infection – especially at the injection site
  • Drastic changes in appetite
  • Hair loss
  • Lethargy or weakness

Carboplatin

Carboplatin is a modified form of cisplatin, a platinum-based chemotherapy drug. Available for use since the mid-1980’s Carboplatin has been used to treat a wide variety of cancers in addition to mesothelioma, such as ovarian, lung, head, and neck cancer. 

Carboplatin therapy is often preferred to cisplatin use because the drug’s side effects are fewer and less-detrimental. In addition, the elimination half-life of the drug is much longer than that of most chemotherapy drugs (over 30 hours) and several studies have shown it to be mildly more effective against certain types of cancer.  

However, carboplatin seriously decreases the body’s ability to fight off infections. It drastically limits the production of white blood cells, an essential immune system component, and can lead to further complications. Carboplatin must also be delivered in higher doses to achieve the same results (as much as four times the amount of normal cisplatin treatments.)

Carboplatin was also created by Bristol-Meyers Squibb and is also injectable via IV.

Gemcitabine

Gemcitabine is a chemotherapy drug originally manufactured by Ely Lilly and marketed as Gemzar. Approved by the FDA in 1996, this drug has undergone multiple formulation changes and is now available in generic form from multiple manufacturers.  

Gemcitabine was originally intended to be an anti-viral drug but researcher discovered it killed leukemia cells in vitro. They then concentrated on the anti-cancer properties and found great success treating pancreatic and bladder cancer. It was soon used to treat malignant pleural mesothelioma as well.
Gemcitabine works by fragmenting cancer cell DNA during replication and disrupting tumor growth.  

Gemcitabine is relatively well tolerated in mesothelioma patients and often only causes mild to moderate side effects, similar to those associated with other chemotherapy drugs. Gemcitbaine is primarily used as part of a chemotherapy cocktail which often include carboplatin or cisplatin.

Alimta

Alimta, also known as Pemetrexed, is the first medication approved by the FDA specifically to fight mesothelioma. It is relatively new but has already gained a reputation for being one of the most effective agents in the fight against pleural mesothelioma. 

Clinical trials at Newcastle Freeman Hospital in Great Britain demonstrated that Alimta rapidly improved the conditions of over half of study participants with measurable tumor reduction in addition to alleviation of symptoms. 

Alimta is most commonly used in combination with cisplatin over a 21 day cycle which includes multiple injections via IV.

Alimta side effects are extremely mild when compared to older chemotherapy drugs such as cisplatin and include fatigue, anemia, fever, upset stomach, and mouth sores. Often doctors prescribe complimentary medications such as antibiotics to help alleviate these side effects. 

Navelbine

Navelbine is a rather new semi-synthetic drug partially derived from plant-based alkaline. It works by interfering with the replication cycle of mesothelioma cells (preventing mitosis – cell division) and has shown effectiveness rates of up to 25% in pleural mesothelioma patients. 

In addition to mesothelioma Navelbine, marketed generically as Vinorelbine, is used to treat non-small cell lung cancer, Hodgkin's disease, breast and ovarian cancer.

Navelbine is available in injection form that is administered intravenously or in pill form. There have been no notable studies examining the effectiveness of oral Navelbine against mesothelioma.

Navelbine has been the subject of several recent clinical studies in which its effectiveness, both singularly and in conjunction with more common mesothelioma drugs, was examined.

Navelbine is surprisingly well tolerated with low levels of minor side effects including hair loss, nausea, anemia and hemorrhaging. Like other IV drugs, careful administration is essential as injection site necrosis (tissue death) and vein thrombosis can occur if used improperly.

Onconase

Onconase, also sold as Ranpirnase, is actually manufactured using extracts from the eggs and stem cells of northern leopard frogs.  It, unlike metal-based chemo drugs, is an enzyme that works in combination with other enzymes to naturally break down RNA, a nucleic acid essential for transfer of genetically coded information. By destroying the RNA, the onconase prevents cancer cells from reproducing. 

Onconase is a targeted treatment and can be used to attack specific cells, including malignant mesothelial cells,  due to its ability to recognize surface proteins on a cell wall. This means that unlike other more accepted mesothelioma treatments, onconase leaves healthy tissue alone.

Onconase is currently undergoing multiple clinical trials and has previously shown promise as a second-line strategy for patients whose cancers have relapsed after more traditional treatments.