Cisplatin is a chemotherapy drug that is made from platinum. Pleural mesothelioma can be treated with the drug cisplatin and the chemotherapy drug pemetrexed. Cisplatin is also used in a number of new ways to treat mesothelioma. Cisplatin can be used in multimodal treatment plans that include HIPEC, immunotherapy, and TTFields. In this article, we'll find out Cisplatin for Mesothelioma Treatment
Describe Cisplatin for mesothelioma
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| Cisplatin for Mesothelioma Treatment: Advantages and Adverse Effects |
Chemotherapy with cisplatin is approved for treating pleural mesothelioma. It used to be sold under the brand name Platinol®-AQ, which has since been taken off the market. Cisplatin is a small molecule that has platinum in it. It can stop cells from growing and dividing, and it can also make cells kill themselves. This can help stop the growth of tumors.
In 2004, the U.S. Food and Drug Administration (FDA) approved cisplatin and pemetrexed as a treatment for pleural mesothelioma. Pemetrexed is often called Alimta®, which is the brand name of the drug. In 1978, the FDA gave cisplatin its first green light as a treatment for testicular and bladder cancer. Chemotherapy with cisplatin is also approved for people with ovarian cancer.
Cisplatin is often used with other chemo drugs to make the treatment work better. The only chemotherapy for mesothelioma that has been approved by the FDA is a combination of cisplatin and pemetrexed. But scientists have looked into what happens when cisplatin is mixed with other drugs. Some studies show that the results are good. Doctors may also use cisplatin with other chemotherapy drugs to treat mesothelioma, such as:
Bevacizumab
Doxorubicin\sGemcitabine
Cisplatin can also be used in conjunction with other treatments. For example, when immunotherapy is used with cisplatin and pemetrexed, the results of the treatment may be better. At least one study showed that this combination had better clinical effects. The results showed that patients with malignant pleural mesothelioma (MPM) lived longer overall.
A Few Facts About Cisplatin
Cisplatin, CDDP are the generic names.
Platinol is no longer made, but Platinol-AQ is (discontinued)
Intravenous (IV) administration
Cisplatin is often used in combination with pemetrexed (Alimta). Both types of chemotherapy work to stop cell growth.
Biphasic mesothelioma, epithelioid mesothelioma, peritoneal mesothelioma, pleural mesothelioma, and sarcomatoid mesothelioma are all types of mesothelioma that can be treated.
Manufacturers: Accord Healthcare, Athenex Pharmaceutical Division, LLC, BluePoint Laboratories, Fresenius Kabi USA, LLC, Gland Pharma Limited, Teva Parenteral Medicines, Inc., West-Ward Pharmaceuticals Corporation, WG Critical Care, LLC.
Cisplatin and pemetrexed have been approved by the FDA as a first-line treatment for pleural mesothelioma. This kind of chemotherapy may be an option for people who can't have a resection. Also approved as a first-line treatment for non-small cell lung cancer is the combination of cisplatin and pemetrexed. Cisplatin can be used on its own to treat non-small cell lung cancer in the second line of care.
How is Mesothelioma treated with Cisplatin?
For treatment of malignant mesothelioma, cisplatin and pemetrexed may be given together to the patient. Cisplatin and pemetrexed are both drugs that are used in chemotherapy. A compound of platinum is used to make cisplatin. It can bind to DNA, which can slow the growth of cancer cells or kill them.
Apoptosis is the process by which cells kill themselves when treated with cisplatin. Apoptosis is a kind of guardrail that keeps cells from doing things that could lead to cancer. If the process of apoptosis doesn't work right, cells can grow out of control and form tumors.
Cisplatin and pemetrexed are the standard first-line treatments for pleural mesothelioma. This combination is also often used as a second-line treatment for pleural mesothelioma.
Cisplatin is also used in some of the newer ways that chemotherapy is given. In procedures called heated intraperitoneal chemotherapy (HIPEC), doctors often use cisplatin. After surgery, HIPEC is a heated chemotherapy wash that is put into the abdomen. It might help people with peritoneal mesothelioma live longer. Cisplatin is also used in procedures called hyperthermic intrathoracic chemotherapy, or HITHOC. HITHOC is like HIPEC, and it may help people with pleural mesothelioma live longer.
For Pleural Mesothelioma, Cisplatin and Pemetrexed are used
In 2004, the FDA approved cisplatin and pemetrexed as a way to treat pleural mesothelioma that couldn't be cut out. Both types of chemotherapy use chemicals to kill cancer cells and stop them from making more of themselves.
In resection, tissue or parts of an organ are cut away. If something is unresectable, it can't be taken out with surgery. Doctors may also say that tumors that can't be cut out are "inoperable."
It is not unusual for more than one drug to be used to treat mesothelioma. Some drugs that kill cancer cells in different ways work well together. Both cisplatin and pemetrexed kill fast-growing cells, but they do it in different ways.
This treatment plan of cisplatin and pemetrexed was approved by the FDA as a first-line treatment for pleural mesothelioma. According to research, this combination works better than cisplatin alone. First-line treatment is any combination of treatments that are used in the first part of a patient's treatment plan. After this first step, the second line of treatment begins.
One study found that the average length of life for people who only got first-line cisplatin chemotherapy was 9.3 months. Those who got cisplatin and pemetrexed lived an average of 12.1 months after treatment. In this study, the survival rate went up by about 30% when pemetrexed was added to cisplatin.
In another study, cisplatin and pemetrexed were used as a second line of treatment. The study found that different treatments for pleural mesothelioma led to different survival rates:
Patients who got cisplatin and pemetrexed lived an average of 15.3 months.
Patients who only got cisplatin: a median survival time of 12.2 months
At the moment, cisplatin plus pemetrexed is the only chemotherapy treatment for pleural mesothelioma that has been approved by the FDA. But cisplatin is usually used with other drugs to treat different kinds of mesothelioma.
Peritoneal Mesothelioma HIPEC uses cisplatin
In certain procedures, oncologists can use cisplatin by itself or with other chemotherapy drugs. For example, cisplatin is often used in HIPEC procedures to treat peritoneal mesothelioma. In one study, people with peritoneal mesothelioma got HIPEC with cisplatin and other treatments. The average length of time these people lived was 52 months.
Heated intraperitoneal chemotherapy is what HIPEC stands for. It is a type of chemotherapy that is heated and given in the abdomen by doctors. Because HIPEC is focused on the abdomen, it may have fewer side effects than traditional chemotherapy. Chemotherapy done the old way is given through a vein and moves through the bloodstream.
Cisplatin and another chemotherapy drug may be used together in other types of HIPEC. For example, cisplatin and doxorubicin can be used together. In one study, 80% of the people in one group were given HIPEC with cisplatin and doxorubicin. The researchers found that the average length of life for all the people in the study was 53 months.
When HIPEC is used to treat peritoneal mesothelioma, cisplatin and mitomycin may also be used. In one study, this type of HIPEC was used as part of a multi-step treatment for patients. The average length of life for people who had HIPEC procedures with cisplatin and mitomycin was 54.9 months.
HITHOC for pleural mesothelioma uses cisplatin
HITHOC procedures, which are similar to HIPEC, can also use cisplatin. Chemotherapy is also used in HITHOC procedures. But HITHOC puts chemotherapy drugs that have been heated in the chest instead of the abdomen. This makes it easier for the drugs to treat pleural mesothelioma tumors.
Hyperthermic intrathoracic chemotherapy is what HITHOC stands for. It is a type of chemotherapy that is heated and given inside the chest cavity. With this method, the chemotherapy drugs stay in one place instead of being spread through the bloodstream. Some of the side effects of traditional chemotherapy given through an IV may not happen with HITHOC.
In one study, people with pleural mesothelioma were given surgery and then HITHOC with cisplatin and doxorubicin. The average time a patient lived after surgery to remove all visible tumors was 28.2 months.
How to Prepare for Treatment
Patients with pleural mesothelioma get infusions of cisplatin and pemetrexed every three weeks as part of their treatment. Over the course of three to six months, a person may have four to six treatments.
Before their first infusion, the patient does things to make sure they have as few side effects as possible. During the week before the infusion:
Folic acid must be taken at least five times a day by the person.
Vitamin B12 must be given through an injection into the muscle.
A dose of a steroid could be given to the patient the day before their first infusion.
Folic acid and B12 supplements will still be given to the patient during and after treatment. They might also get more steroid shots on the day of treatment and the day after.
People who have pleural mesothelioma will get their infusion at a hospital. Their IV treatments are given to them in stages. The size of the patient's skin is used to figure out the dose at each stage. Square meters are used to measure the doses.
Stage 1: Pemetrexed infusion at 500 mg/m2 over 10 minutes
Stage 2: Rest for 30 minutes
Stage 3: A two-hour drip of 75 mg/m2 of cisplatin
Doctors and nurses will keep an eye on this procedure to make sure it is safe. They will watch the number of blood cells, how well the kidneys work, and how well the liver works.
The person will rest for three weeks after their first infusion. The patient may then come back for the next round of care. If they get another infusion, it will take them more time to rest and get better.
No one knows how many times this cycle will happen. A doctor will make a recommendation based on what the person needs. One study found that at least six cycles of treatment with cisplatin and pemetrexed were given to more than half of the people with pleural mesothelioma.
How to Get Ready for Your Visit
Patients can do things to get ready for their chemotherapy. Some steps can help patients feel less stressed and stay on top of things. Patients who have an appointment may want to:
Patients may feel tired after their treatments, so make sure they have a way to get home. It's a good idea to have a friend, family member, or service pick you up at the hospital and take you home.
Patients should clear their schedules so they have time to rest and heal after their appointment. They should also let their employers know that they may need time off for treatment and recovery.
Dress comfortably, because people will be sitting for a long time while getting treatment. Putting on warm, loose clothes can help keep you from feeling bad.
Organize their medical information: Patients should be ready to talk about their cancer journey if they are asked. Keeping this information in order can help keep you from getting stressed.
Pack a bag: Patients should pack a bag with things that will be helpful during treatment. There are snacks, water, arts and crafts, and books.
Doctors will talk to their patients about the chemotherapy drugs they will be taking before they start treatment. Patients with mesothelioma can ask their care team anything they want to know about how to get ready for chemotherapy.
Taking care of treatment and after-care
Chemotherapy may be given more than once to a person with pleural mesothelioma. One study found that patients are likely to need at least six cycles of treatment with cisplatin and pemetrexed. During treatment cycles with cisplatin, it's important for people to take it easy.
Cisplatin patients can do a number of things to help with their treatment, such as:
- Keeping away from places where they could get sick
- Getting enough sleep
- Keeping yourself wet
- Handwashing
Mesothelioma doctors will keep an eye on how their patients are doing during treatment and give them care afterward. During treatment with cisplatin, patients are likely to have follow-up appointments. Doctors may take blood to look at the number of blood cells. They may also check a patient's electrolytes and how well organs like the kidneys and liver are working. Also, they will watch for any allergic reactions.
It's important for patients to show up to their appointments. They should also think about how their treatment is going and talk to their doctor about it. A doctor can help you get any follow-up care you need and treat any side effects of chemotherapy.
Benefits and Advantages of Cisplatin mesothelioma
People with pleural mesothelioma can get better results from cisplatin and pemetrexed. This treatment may help people who can't have surgery live longer. It is the only chemotherapy treatment for pleural mesothelioma that has been approved by the FDA.
Cisplatin has also been used in new ways of giving chemotherapy that have worked well. Using cisplatin in HIPEC may help people with peritoneal mesothelioma live longer. Patients with pleural mesothelioma may live longer if cisplatin is used in HITHOC procedures.
There may also be benefits to combining cisplatin and pemetrexed with other types of treatment. For instance, research has been done on:
Immunotherapy for Getting Rid of Tumors (TTFields)
Some studies show that using these treatments with cisplatin and pemetrexed might be helpful.
Adverse Effects of mesothelioma Cisplatin
Patients with malignant mesothelioma who get cisplatin chemotherapy may have side effects. People often feel sick and throw up. There are many things that could cause side effects. For example, the side effects of a drug may be different if it is used with other treatments.
The combination of cisplatin and pemetrexed, which has been approved by the FDA, is usually well tolerated by patients. Patients may feel sick, throw up, feel tired, and lose their appetite. They might also lose or have less hair because of the pemetrexed. But there isn't much chance that pemetrexed will cause hair loss.
Before their first chemotherapy appointment, people should talk to their doctors. A doctor who treats mesothelioma can talk about possible side effects. They can also help you deal with any side effects of treatment.
- Anemia is a possible side effect of Cisplatin.
- Diarrhea
- Ear poisoning
- Hearing damage
- A heart attack
- Heart damage
- Liver damage
- Loss of hunger
- Low number of platelets
- Low numbers of white blood cells
- Nausea
- Peripheral nerve damage (weakness, numbness or pain from nerve damage)
- Kidney damage (kidney damage)
- Major immune response
- Vision damage
- Is Vomiting
Taking care of side effects
Mesothelioma patients may be able to deal with the side effects of chemotherapy in more than one way. Vitamin B12 injections will be given to people who are on the cisplatin and pemetrexed treatment plan. They might also get shots of steroids. These can be used to help with side effects before, during, and after treatment.
One common effect of cisplatin is to make people feel sick. People with nausea may be able to feel better by changing what they eat before, during, and after chemotherapy. A doctor may also give you medicine to stop feeling sick. The patient should follow the directions for any medicine that was given to them.
If a person has any side effects, they should talk to their doctor. Before taking any new drug or supplement, they should also talk to their mesothelioma doctor. A doctor can tell a patient if it is safe to take the drug or supplement with cisplatin. Taking care of side effects can help improve the quality of life of a patient who is getting treatment.
Who is a good candidate for Cisplatin?
People with pleural mesothelioma who can't have surgery may be able to get cisplatin plus pemetrexed. There are other things that could affect a patient's eligibility, such as:
Performance status is another name for the ability to do daily tasks.
Drug allergies
The patient is also taking other medicines.
Heart disease, kidney disease, and liver disease were already there.
Patients with mesothelioma should talk to their doctor to find out if they are eligible. A doctor can tell you about the pros and cons of cisplatin and answer any questions you might have. They can also tell people about other ways to treat mesothelioma.
Cisplatin clinical trials for mesothelioma
Cisplatin is being tested and used in new ways to treat mesothelioma in clinical trials and studies. When used with other drugs and treatment methods, cisplatin has been shown to be helpful. Combinations are still being tested in clinical trials that are still going on to make better patient outcomes.
In one study, the immunotherapy drug bevacizumab was added to the combination of cisplatin and pemetrexed that was approved by the FDA. Bevacizumab helps stop cancer cells from getting the blood they need. The study looked at the outcomes for people with pleural mesothelioma. Patients who took all three drugs together lived for an average of 18.8 months. The average length of life for people who only got cisplatin and pemetrexed was 16.1 months.
In another study, 104 people who had surgery for pleural mesothelioma were looked at. Either an extrapleural pneumonectomy (EPP) or a pleurectomy/decortication (P/D) was done on the patients. Then, the chest cavity of the patient was filled with a mixture of heated cisplatin and gemcitabine. This means that the patients had HITHOC with cisplatin after surgery.
Patients with epithelioid mesothelioma who had either type of surgery did well, according to the study. The average length of life for EPP patients was 25.6 months. With P/D, the average length of life was 41.6 months.
Cisplatin and Other Therapeutic Methods
Researchers are looking into how well other treatments work with cisplatin and pemetrexed. Immunotherapy, targeted therapy, and TTFields are all types of multimodal therapies that use cisplatin and pemetrexed.
Combining immunotherapy with cisplatin and pemetrexed to treat pleural mesothelioma has shown some positive results. For example, researchers have looked into how durvalumab might help people.
Immunotherapy is a type of treatment that Durvalumab is a part of. When durvalumab was used with cisplatin and pemetrexed, one study found that the average length of life was 20.4. In the clinical trial for cisplatin and pemetrexed alone, the average amount of time that pleural mesothelioma patients lived was 12.1 months. This means that adding durvalumab to cisplatin and pemetrexed might have added about 8 months to how long people lived.
In one study, TTFields was used with the chemotherapy drugs cisplatin and pemetrexed. TTFields are very weak electric fields that help stop cells from dividing. The health of people with pleural mesothelioma got better.
In another study, the effects of using targeted therapies along with cisplatin and pemetrexed were looked at. Targeted therapies are things that stop cancer cells from multiplying. Chemotherapy and immunotherapy are not the same as these. This study looked at how the kinase inhibitor nintedanib works when it is mixed with cisplatin and pemetrexed.
Patients with pleural mesothelioma who had the epithelioid cell type benefited from this method. Patients who only got chemotherapy lived on average for 15.2 months. When chemotherapy and nintedanib were given to patients, the results got better.
Getting Mesothelioma Cisplatin to work better
Researchers are trying to figure out how to make cisplatin work better. One study looked at how to get cisplatin to work better with chemotherapy. Cancer cells didn't seem to be able to defend themselves against chemotherapy because of a certain compound. Researchers think that this compound could make cisplatin work better in the long run.
Studies like these try to improve how well the drug fights cancer. If cisplatin works better, it may help mesothelioma patients live longer.