Can pemetrexed help in malignant mesothelioma?

Mesothelioma is a cancer that originates in the pleura or, more rarely, the peritoneum, and is almost always due to exposure to asbestos fibres. It is typically fatal, with a median survival of about 8-14 months after diagnosis. Conventional treatment options have not improved this poor outlook. Also, the number of deaths attributable to malignant mesothelioma has been rising rapidly in the UK since the late 1960s, and is set to peak at about 1,950-2,450 per year between 2011 and 2015. It is against this background that pemetrexed (pronounced pe-me-treks-ed) (Alimta - Lilly) has recently become available for use with cisplatin for the treatment of patients with unresectable malignant pleural mesothelioma who have not previously been treated with chemotherapy. Currently, this is the only chemotherapy regimen licensed for patients with malignant pleural mesothelioma in the UK. Here we review the care of patients with malignant pleural mesothelioma, focusing on what, if anything, pemetrexed might offer such individuals.