Tuesday, July 12, 2011

Mesothelioma Drugs

* Mesothelioma Drugs

    A diagnosis of mesothelioma will normally be followed by several discussions with your oncologist. Such topics of discussion will cover prognosis and treatment options to battle the disease. More often than not, the course of treatment can include a variety of mesothelioma drugs and medications.
Alimta - Mesothelioma Chemotherapy Drugs
    Historically, mesothelioma has been one of the most difficult forms of asbestos cancer to treat. Though doctors have been prescribing chemotherapy for decades, few chemotherapeutic agents have had much effect on the aggressive disease.
    Among recently approved medications, Alimta stands out as having the most promise in prolonging the life of mesothelioma patients, as well as improving their quality of life.
    Alimta (Pemetrexed) is a newer chemotherapy medication that was approved by the Food and Drug Administration (FDA) in 2005. Often used in conjunction with Cisplatin, Alimta is the first medication that is specifically approved for the treatment of mesothelioma and is considered to be the most effective chemotherapy treatment for pleural mesotheliomapatients that are not candidates for surgery.
    Alimta is a multi-targeted anti-folate medication that works by blocking the enzymes required for DNA replication and cell division. During clinical trials, Alimta (used in tandem with Cisplatin) added an average of three months to the lives of malignant mesothelioma patients and also helped to reduce symptoms.

AlimtaTreatments

    As with any medication, it is imperative for patients to discuss the use of Alimta and Cisplatin with their doctor before beginning cancer treatment. An oncologist will provide facts about the effectiveness of Alimta, the administration of the medication, and the side effects patients encounter. When beginning treatment with Alimta, cancer doctors will also recommend B12 supplements by injection and folic acid supplements by mouth daily (supplementation will continue for 21 days after the last dosage cycle of Alimta). Physicians will also prescribe an oral steroid to help minimize side effects. Patients should inform their doctor of all other medications being taken to avoid dangerous interactions.
    Alimta is given to mesothelioma patients every 21 days on an outpatient basis. Treatment consists of a 10-minute IV infusion, followed by two hours of Cisplatin. The number of cycles patients are required to receive will depend on their response to the medications and intensity of resulting side effects.

Side Effects of Alimta

    The side effects of Alimta are usually mild to moderate for most patients with pleural mesothelioma. Some patients may experience extreme side effects and a doctor should be informed immediately if a reaction becomes a serious problem. Side effects typically include:
  • Nausea
  • Vomiting
  • Fatigue
  • Constipation
  • Diarrhea
  • Loss of appetite
  • Weight loss
  • Tiredness
  • Weakness
  • Pale skin
  • Headache
  • Dizziness
  • Confusion
  • Fast heartbeat
  • Difficulty falling asleep or staying asleep
  • Changes in mood
  • Depression
  • Joint or muscle pain
  • Low red blood cells (anemia)
  • Low white blood cells (neutropenia)
  • Low platelets (thrombocytopenia)
    Patients experiencing any of the following symptoms should immediately call their doctor:
  • Diarrhea
  • Sores in the mouth, throat, or on the lips
  • Unusual bleeding or bruising
  • Sore throat, fever, chills, cough, or other signs of infection
  • Chest pain
  • Difficulty breathing or swallowing
  • Slow or difficult speech
  • Weakness or numbness of an arm or leg
  • Pain, burning, numbness, or tingling in the hands or feet
  • Hives
  • Rash
  • Itching
  • Decreased urination
    Mesothelioma patients should avoid being near people who have colds, the flu, or other signs of illness. Make sure to contact your doctor at once if you develop signs of an infection. Before you receive Alimta, tell your doctor if you are taking an NASAID, such as ibuprofen, naproxen, indometacin, ketoprofen, and others. Also before receiving Alimta, tell your doctor if you have kidney disease, liver disease, a weak immune system, or excess fluid in the space around your lungs, liver, or other internal organs.

- Cisplatin and Mesothelioma Chemotherapy

    Cisplatin is a platinum-based chemotherapy drug that is used to treat a variety of cancers, including mesothelioma. It was first approved by the Food and Drug Administration (FDA) in 1978 and is still being used for treatment today. Platinum agents such as Cisplatin have been studied as single agents and in combined regimens for malignant pleural mesothelioma.
    As a single agent, Cisplatin has a relatively low response rate of less than 15 percent in most reported pleural mesothelioma cases. However, when combined with other chemotherapy medications, patients have experienced improved response rates. For example, the combination of Cisplatin and Pemetrexed (Alimta) has become the most effectivechemotherapy regimen for pleural mesothelioma patients that are not candidates for surgery. Treatment with this therapy has been shown to prolong life expectancy and response rates tend to be under 50 percent.

Cisplatin in Mesothelioma Treatment

    Throughout treatment, mesothelioma patients receive the combination of Cisplatin and Alimta every 21 days. The medication Alimta is given through an IV and typically takes about 10 to 15 minutes to complete. A dose of Cisplatin follows this step and usually takes about two hours to administer. The dose and number of cycles required will depend on the patient’s response to treatment as well as any side effects experienced.
    The basic use of Cisplatin is to promote apoptosis, or cell death. It is recommended to patients who are treated with Cisplatin to start taking a B12 supplement orally one week before treatment begins. Patients will likely receive weekly B12 shots throughout treatment in addition to taking a daily folic acid supplement, which will continue for 21 days after the last treatment cycle. An oral steroid may be prescribed to minimize side effects.
    In unique cases, high doses of Cisplatin combined with doxorubicin have been effective in sending mesothelioma into partial remission. It should be noted that three other trials using more conventional doses of Cisplatin and doxorubicin produced positive response rates that are inversely correlated with the number of patients evaluated: 67 percent in 6 patients, 42 percent in 19 patients, and 25 percent in 24 patients. Such statistics indicate that results from a small series of patients should await confirmation from larger clinical trials.
    Promising results have also been noted in the combination of Cisplatin and gemcitabine in Australia, with a partial response rate of 47.6 percent among 21 patients. Median survival was 41 weeks (about 10 months). Most of the responses were seen in mesothelioma patients diagnosed with the epithelioid subtype and symptom relief was correlated with response to treatment.
     In a previous study, Dr. Sugarbaker and other researchers combined extrapleural pneumonectomy with radiation to the hemithorax and chemotherapy with Cisplatin, doxorubicin and cyclophosphamide in 120 patients. The overall survival was 45 percent at two years and 22 percent at five years.

Cisplatin Side Effects

    Side effects that may be experienced by mesothelioma patients receiving the chemotherapy drug Cisplatin include:
  • Fatigue
  • Nausea
  • Vomiting
  • Hair loss
  • Diarrhea
  • Hearing loss
  • Kidney toxicity
  • Changes in taste
  • Low red blood cells (amemia)
  • Low white blood cells (neutropenia)
  • Numbness or tingling in the fingertips and toes
    Many of these side effects will subside when treatment ends. Mesothelioma patients that experience any of the following symptoms after receiving Cisplatin should notify their doctor:
  • Fever
  • Chills
  • Dizziness
  • Diarrhea
  • Seizures
  • Rash
  • Black stools
  • Unusual bruising or bleeding
  • Swelling of the feet or ankles
  • Shortness of breath or wheezing
    In some cases, patients receiving the chemotherapy drug Cisplatin can experience extreme side effects such as severe organ damage. The central nervous system can also be affected by alkylating-like agents.

Want to Learn More About Cisplatin?

    Mesothelioma patients considering chemotherapy as a treatment option should discuss any concerns with a qualified doctor. Although Cisplatin is not the only chemotherapy medication used for the treatment of mesothelioma cancer, it is the most common and patients should learn as much as they can about their options.

- Onconase - Mesothelioma Chemotherapy Drugs

    Onconase, which is also known as Ranpirnase and P-30 protein, is a derivative of the eggs and early embryos of the northern leopard frog. It is also an enzyme that speeds up another enzyme that specializes in the breakdown of RNA. To date, several studies have shown that Onconase can be used to kill mesothelioma cancer cells while sparing normal cells throughout the body.
    The clinical trial that originally tested Onconase was conducted at Columbia University. The trial's coordinator, Dr. Robert Taub, performed a two-phase study involving 105 patients who had advanced metastasizing mesothelioma. During the clinical trial, Onconase was given to patients through an IV for more than 30 minutes each week.
    The median survival time for these patients was nearly six months, and some patients achieved one and two-year survival rates. Because the results were so encouraging, a Phase III clinical trial of Onconase was conducted with a comparison of doxorubicin in patients who had unresectable malignant mesothelioma. The survival rates were similar between the two groups of Onconase trials, as well as for the trial of doxorubicin. However, the results in the test trials of Onconase versus doxorubicin favored Onconase.

Treatment of Mesothelioma with Onconase

    Onconase is one of the first biopharmaceutical products that works in a similar fashion to RNA interference (RNAi) that has reached late-stage clinical trials. The medication has recently shown a tremendous amount of promise and may be considered a potentialtreatment for mesothelioma in the future. In fact, those who have been exposed to asbestos might even be able to prevent the onset of mesothelioma.
    Currently, the only way to receive this chemotherapeutic medication is through the enrollment of a clinical trial. Mesothelioma patients that are interested should ask their doctor if they are a potential candidate for Onconase clinical trials. Studies have shown the most common side effects include nausea, fatigue, and alopecia (hair loss).

- Gemcitabine - Mesothelioma Chemotherapy Drugs

    One of the chemotherapeutic drugs available for the treatment of mesothelioma is Gemcitabine, most often used to treat pancreatic, bladder, and breast cancers. Doctors have also found some success with Gemcitabine in the treatment of certain types of lung cancer(including pleural mesothelioma), and often use the drug in combination with another chemotherapy drug to treat these forms of cancer.
    Most chemotherapeutic drugs, including Gemcitabine, work simply by killing cells with complex chemical reactions. Gemcitabine can slow the growth ofasbestos cancers by killing existing cancer cells and interfering with DNA replication in other cells.
    Chemotherapeutic drugs such as Gemcitabine target cells that are dividing rapidly, including cancer cells. Unfortunately, the treatment may also affect some healthy cells, including cells that are involved in hair growth and immunity cells. This is why many chemotherapy patients lose hair and become easily susceptible to illness.

Gemcitabine Treatment for Mesothelioma

    Gemcitabine chemotherapy is most often performed on an out-patient basis and is administered intravenously. Treatment with Gemcitabine typically involves a trip to a doctor's office, clinic, or hospital. The procedure usually takes a few hours, with the actual administration of Gemcitabine lasting around 30 minutes. In most cases, Gemcitabine is administered once a week for up to seven weeks, though the length of treatment and strength of dosage will depend on the type and stage of cancer being treated.
    When considering treatment with Gemcitabine it is necessary for patients to inform their doctor of current medications being taken, including all prescription drugs and any supplements or over-the-counter medications. In addition, anyone who has impaired liver or kidney function is generally not advised to use Gemcitabine, as the drug can cause severe liver and kidney damage. Since Gemcitabine and most chemotherapy drugs are known to be harmful to unborn babies, women who are pregnant or breastfeeding should not use this drug.

Side Effects of Gemcitabine

    Side effects of treatment with Gemcitabine include the following:
  • Nausea and vomiting
  • Tendency to bruise or bleed easily
  • Constipation or diarrhea
  • Swelling in the ankles, feet, or hands (edema)
  • Less frequent urination
  • Blood in urine, or particularly dark urine
  • Change in kidney function
  • Change in liver function
  • Chest pain
  • Numbness or weakness, most often on one side of the body
  • Confusion, balance impairment, or impaired vision or speech
  • Fever, chills, aching body (similar to symptoms of flu)
  • Sores or white patches inside the mouth
  • Pain or swelling at the location where Gemcitabine was administered
    Those who are treated with Gemcitabine (and other chemotherapy drugs) have reduced immune system function since the drug kills certain immune cells. If you are taking Gemcitabine for mesothelioma, it's important to avoid contact with people who have colds or other infections.

- Carboplatin - Mesothelioma Chemotherapy Drugs

    Since chemotherapeutic drugs have been available for the treatment of mesotheliomadoctors have been experimenting with a variety of different chemotherapy drugs, including Carboplatin.
    Introduced in the late 1980s, Carboplatin is favored by many physicians because its side effects are much less severe in comparison to many other chemotherapeutic drugs, particularly Cisplatin, which is the 'parent' drug of Carboplatin (meaning that Carboplatin is a modified form of Cisplatin). Carboplatin is most commonly used to treat ovarian, lung, head, and neck cancers, but has also shown some success in treating mesothelioma.
    Most chemotherapeutic drugs, including Carboplatin, are designed to kill cancer cells. Carboplatin works by breaching the cellular wall and binds to the cell's DNA, preventing the cell from dividing and functioning normally, which eventually kills the cell. These drugs tend to target cancer cells because they are attracted only to cells that divide rapidly.

Mesothelioma Treatment with Carboplatin

    Carboplatin chemotherapy is typically administered on an out-patient basis at a hospital orcancer treatment center. The medication is given intravenously, usually once every 28 days. In cases where a patient with mesothelioma requires more frequent chemotherapy, or where Carboplatin treatment is combined with other treatments or drugs, it may be administered on an in-patient basis, requiring a stay of two or more consecutive days in the hospital.
    Anyone with kidney disease is discouraged from seeking treatment with Carboplatin. It should be noted that Carboplatin, like most chemotherapy drugs, is harmful to unborn babies. Thus, women who are pregnant or breastfeeding should not use this drug.

Side Effects of Carboplatin

    Side effects of Carboplatin are typically less severe than those associated with most other chemotherapeutic agents. However, patients taking this medication can still expect to experience some unpleasant side effects, which may include:
  • Hair loss
  • Impaired immune function
  • Nausea and vomiting
  • Fatigue
  • Loss of appetite
  • Constipation
  • Stomach pain
  • Impaired vision or hearing
  • Feelings of fatigue or weakness
  • Increased tendency for bruising or bleeding (due to poor clotting)
    Patients experiencing the following should immediately call their doctor:
  • Red urine
  • Dizziness or feeling of faintness
  • Black, tarry stools
  • Fever
  • Chills
  • Shortness of breath or wheezing
  • Swelling of the feet or ankles
  • Rash
    Those treated with Carboplatin for mesothelioma typically experience reduced immune system function and become more prone to infection. This means even a cold may be dangerous to a patient receiving this treatment. Anyone receiving treatment with Carboplatin should avoid contact with people who have colds or other infections.
    A potentially serious side effect of Carboplatin is kidney damage. The symptoms of kidney damage usually include pain or difficulty in urinating, or the appearance of blood in the urine.
    The appearance of any side effects, whether mild or serious, should be discussed with a doctor as soon as they arise. A cancer doctor may be able to prescribe medication to help alleviate certain side effects, such as nausea, vomiting, and loss of appetite. To avoid potential life-threatening complications, anyone who is taking Carboplatin should seek medical advice if they contract any kind of infection or experience fever, chills, rash, or sore throat.

- Navelbine - Mesothelioma Chemotherapy Drugs

    Navelbine (also known as Vinorelbine) is relatively unique among chemotherapy drugs used for the treatment of mesothelioma because most chemotherapy drugs are entirely synthetic, whereas Navelbine is a semi-synthetic drug that is extracted from a flowering plant known as periwinkle.

Navelbine for Mesothelioma Treatment

    Most chemotherapeutic drugs, including Navelbine, work by entering cells and binding to structures that are essential in cell division. This prevents cells from dividing, and because the cells cannot function normally, a form of "cellular suicide" takes place. Thus, Navelbine can both slow the spread of cancers and kill existing cancer cells.
    Relatively new on the treatment scene, Navelbine has shown a slightly higher success rate than some other chemotherapy drugs in the treatment of mesothelioma.
    Often used in conjunction with other treatments such as surgery, or in tandem with other chemotherapeutic agents, Navelbine is typically administered once a week for several weeks. The drug is injected intravenously on an out-patient basis and the procedure usually takes around 30 minutes to an hour. The number of treatments a patient will receive is determined by the location and development of cancer.
    When discussing treatment options with a doctor it is important to inform them of any other medical conditions, such as kidney or liver problems. In addition, patients must inform their doctor of other medications being taken to avoid possible complications.

Side Effects of Navelbine

    Those taking Navelbine for mesothelioma treatment might experience side effects that may become serious if left untreated. All severe side effects should be reported to a medical professional and may include:
  • Allergic reaction (symptoms may include difficulty breathing, swelling of the lips, tongue, or face, or hives)
  • Extreme fatigue, tendency to bruise or bleed easily, blood in stool, chills, fever, or other signs of infection. These symptoms indicate decreased bone marrow function and increased vulnerability to infection.
  • Pain, swelling, or redness at the injection site
  • Constipation or abdominal pain
  • Cough or difficulty breathing
  • Chest pain, numbness, or tingling
    Less serious side effects may include:
  • Minor feelings of fatigue
  • Hair loss
  • Nausea, vomiting, loss of appetite, and diarrhea
  • Inflammation or soreness inside the mouth or on the lips
    It is very important to note those being treated with Navelbine are much more vulnerable to infection. As such. those receiving treatment should avoid contact with people who have colds, the flu, and other contagious conditions.




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