Mesothelioma chemotherapy can make you itch and break out in a rash, or cause you any number of other skin problems. Thankfully, there are remedies to relieve such side effects.
Now, scientists are looking more closely at one of those available remedies. They have come up with a better way to take pemetrexed if it’s part of your mesothelioma chemotherapy regimen.
The maker of branded pemetrexed has traditionally advised mesothelioma doctors to give dexamethasone to patients before starting them on chemotherapy.
The drugmaker’s recommendation calls for mesothelioma patients to receive 4 mg of dexamethasone twice a day over a span of three days — the day before, the day of, and the day after chemotherapy.
That adds up to a total of six administrations of dexamethasone. This works adequately for a lot of patients. But, for others, it does not.
Why Mesothelioma Chemotherapy Pretreatment Can Fail
Upon investigation, researchers found that a prime factor in the failure of dexamethasone pretreatment to help was the failure of the patients to take all six doses as required.
Patients might take the first one or two, but forget to take any more dexamethasone doses after that.
Or they might take the first dexamethasone dose and not take another one until a few days after the mesothelioma chemotherapy.
Regardless of how or why they missed or skipped dexamethasone doses, the fact is doses were not taken.
As a result, these patients did not receive enough dexamethasone to do the job of preventing skin problems from mesothelioma chemotherapy.
So researchers next wondered if this problem of doses being missed could be solved by having patients take just one big single dose of dexamethasone and be done with it.
They subsequently discovered that the answer is yes.
Writing in the Journal of Oncology Pharmacy Practice, the researchers said that a single, 20 mg dose of dexamethasone is just as effective as the six doses of 4 mg dexamethasone.
Mesothelioma Treatment Study Results Look Good
Pemetrexed is an antifolate antimetabolite agent. It is often paired with another mesothelioma chemotherapy agent, cisplatin.
Mesothelioma doctors typically administer cisplatin and pemetrexed when they need to deliver a powerful punch against mesothelioma that has progressed too far to be treated with surgery.
The researchers – from the Appalachian Regional Healthcare Cancer Center in Hazard, Kentucky; the University of California at San Francisco; Stanford Cancer Institute in Stanford, California; and Ohio Northern University in Ada, Ohio — wrote that they tested the single 20-mg dose on 14 patients.
Each patient was slated to begin chemotherapy that included pemetrexed.
A grading system of 1 to 5 was used to score adverse skin reactions, with 5 being worst. Among the takers of single high-dose dexamethasone, no one suffered worse than a Grade 2 skin reaction.
That was quite good, the researchers assured. Also, the skin reactions experienced by the study subjects lasted only a short time.
The bottom line is that adverse skin reactions to chemotherapy are par for the course. However, dexamethasone taken this way before starting mesothelioma chemotherapy appears to be a wise choice for many patients.