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Nursing considerations for administering pemetrexed (Alimta) in combination with cisplatin for malignant pleural
1cmorb@aol.com
Abstract:
No known cure exists for malignant pleural mesothelioma (MPM). The prognosis for patients with this relatively rare, asbestos-related malignancy of the pleural lining of the lung is quite poor. MPM treatment includes surgery, radiotherapy, and chemotherapy. Few patients, however, are candidates for surgery or radiotherapy, so chemotherapy is the only option for most patients. A phase III study found that pemetrexed and cisplatin chemotherapy significantly improved survival and had greater antitumor activity than cisplatin alone. The U.S. Food and Drug Administration recently approved pemetrexed with cisplatin for treating MPM. Nurses should become familiar with the proper preparation and administration of pemetrexed, including the necessity of supplementation with folic acid and vitamin B12. As with all drugs, careful attention must be paid to patient selection, laboratory monitoring, contraindications, and appropriate interventions in the event of adverse reactions or overdose.
Insights
Pemetrexed and cisplatin chemotherapy offers improved survival and antitumor activity for malignant pleural mesothelioma (MPM) patients. This combination is now FDA-approved, requiring careful nursing administration and monitoring.
Area of Science:
- Oncology
- Thoracic Surgery
- Pharmacology
Background:
- Malignant pleural mesothelioma (MPM) is a rare, asbestos-related lung cancer with a poor prognosis.
- Treatment options are limited, with chemotherapy being the primary modality for most patients.
- Surgical and radiotherapy options are not suitable for many MPM patients.
Purpose of the Study:
- To evaluate the efficacy of pemetrexed plus cisplatin chemotherapy for MPM.
- To report on the recent FDA approval of this chemotherapy regimen.
- To inform healthcare professionals, particularly nurses, on the administration of pemetrexed.
Main Methods:
- A phase III clinical study was conducted to compare pemetrexed plus cisplatin with cisplatin alone.
- Data on survival and antitumor activity were collected and analyzed.
Main Results:
- Pemetrexed and cisplatin significantly improved survival in MPM patients compared to cisplatin alone.
- The combination therapy demonstrated greater antitumor activity.
- The U.S. Food and Drug Administration approved pemetrexed with cisplatin for MPM treatment.
Conclusions:
- Pemetrexed plus cisplatin is an effective chemotherapy regimen for malignant pleural mesothelioma.
- Healthcare providers must be knowledgeable about pemetrexed preparation, administration, and patient monitoring.
- Supplementation with folic acid and vitamin B12 is necessary during pemetrexed treatment.
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