Report Notes Unusual Side Effects from Alimta Chemotherapy

A report in the March 2013 edition of the medical journal, Lung Cancer, details two unusual side effects seen in a 77 year-old man who was receiving Alimta chemotherapy in the course of maintenance therapy for malignant pleural mesothelioma (“MPM”). One week after the patient received his seventeenth cycle of Alimta, he began suffering from neutropenic enteritis (“NE”), a potentially life-threatening condition associated with inflammation of the cecum or bowels which was treated with antibiotics. Another side effect experienced by the same patient was severe hyperpigmentation, which is the discoloration or darkening of the skin all over the patient’s body.

There are prior reports of two patients receiving Alimta in the treatment of non-small cell lung cancer who developed NE, but this is the first documented case of an MPM patient exhibiting NE. Hyperpigmentation has been documented in two previous patients receiving Alimta. But this is the first case where both symptoms/side effects were exhibited in the same patient.

Since its approval by the FDA in 2004, pemetrexed, brand name Alimta, has been routinely prescribed in combination with cisplatin or carboplatin for patients diagnosed with mesothelioma. To this day, Alimta/cisplatin remains the only FDA approved chemotherapy drug combination for the treatment of mesothelioma.

Even though it was ultimately approved, the clinical trials of Alimta/cisplatin showed only a 41% partial response rate and an increased median survival rate of only 2.8 months compared to patients treated with cisplatin alone. Furthermore, in its approval letter, the FDA noted that it’s approval of Alimta/cisplatin was limited to “use with patients who are not eligible for surgery.”

More recent published trial data reveals that a combination of surgery, radiation, and chemotherapy is almost always associated with the longest survival times. 

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