Researchers affiliated with a multi-center U.S. trial reported in the July 20, 2008 issue of the Journal of Clinical Oncology that the combination of Alimta® (pemetrexed) and Gemzar® (gemcitabine) was active in patients with peritoneal mesothelioma.

Peritoneal mesothelioma is much less common than pleural mesothelioma, making up less than 20% of all cases. Moreover, the latency period for peritoneal mesothelioma (sometimes referred to as abdominal mesothelioma) appears to be 20-30 years, which is shorter than the latent period for pleural mesothelioma. The most common treatment strategy for peritoneal mesothelioma involves a multimodality approach with surgical debunking followed by systemic and/or intraperitoneal chemotherapy.

Due to the relative rarity of this disease, controlled trials of various treatment options are not available for peritoneal mesothelioma. Therefore, few studies of chemotherapy for peritoneal mesothelioma, treatment regimens are derived from studies in patients with pulmonary mesothelioma.

This current study involved 20 patients treated between 2002 and 2004. Patients received Alimta and Gemzar every 21 days. In addition, patients also received folic acid, vitamin B12, and dexamethasone. The results from the study are listed below.

- The overall response rate was 15%.

- The disease control rate was 50%.

- The median time to disease progression was 10.4 months.

- The median survival time was 26.8 months.

- Toxicities appeared to be tolerable but with a grade 3-4 neutropenia rate of 60%.

The researchers have concluded that Gemzar and Alimta is an active regimen that is an alternative to standard therapies. This is one of the first studies devoted to systemic chemotherapy treatment of peritoneal mesothelioma and provides important baseline information.

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