Taking Vitamin B12 the Day You Start Mesothelioma Chemotherapy

Doctors routinely have you start taking vitamin B12 in the days before you begin mesothelioma chemotherapy that uses the drug pemetrexed.

You take B12 to counteract an effect pemetrexed has on your body. Among the things pemetrexed does is it interferes with your body’s natural production of folate.

You need folate because it helps keep your red and white blood cells, and your blood platelets, at their proper levels. You get folate naturally from eating lettuce and other green leafy vegetables.

Scientists agree that vitamin B12 can help prevent folate deficiency — either the kind that comes from not eating right or from mesothelioma chemotherapy with pemetrexed.

What they can’t agree on is how many days before your mesothelioma chemotherapy begins to start you on B12.

Is it one day before? Is it two days before? Three? Five? Seven? This matters because doctors want to give you the best chance of avoiding folate deficiency during mesothelioma chemotherapy.

Researchers from Roswell Park Cancer Institute in Buffalo, New York, say they have evidence that it’s OK if you start taking B12 right when you first begin receiving pemetrexed.

“Same-day administration of vitamin B12 and pemetrexed is a safe practice in patients with malignant pleural mesothelioma,” they said.

Effects of Vitamin B12 on Mesothelioma Patients

The researchers shared their findings with other mesothelioma fighters gathered at the annual meeting of the American Society of Clinical Oncology in Chicago.

Their presentation was titled “Effect of Timing of Vitamin B12 Supplementation in Patients Receiving Pemetrexed for Treatment of Advanced Non-Squamous Non-Small Cell Lung Cancer or Malignant Pleural Mesothelioma.”

The Roswell Park team reminded their audience that pemetrexed is a first-line chemotherapy drug for mesothelioma. It’s usually given together with a platinum-based drug, such as cisplatin.

In conducting their vitamin B12 study, the researchers went back and examined the medical charts of patients who received pemetrexed for mesothelioma chemotherapy, both alone and paired with a platinum agent.

There were 281 patients in this study. The researchers divided them into two groups. Group A had 137 patients. Group B had 144.

All of these patients were given two cycles of chemotherapy with pemetrexed between Jan. 1, 2012, and June 30, 2015.

Side Effects of B12 on Chemo for Mesothelioma

Half the patients had received vitamin B12 seven days before starting chemotherapy. At least one patient started taking B12 supplements 42 days before starting chemotherapy.

Group A patients were started on vitamin B12 the same day they started their first cycle of pemetrexed. Group B patients were started on the vitamin one or more days before receiving pemetrexed.

The researchers said blood draws that were performed on the patients measured oxygen-carrying blood proteins, platelets and neutrophils. All of these were found to be at levels pretty much the same from group to group.

The researchers also said side effects seen in both groups included fever and anemia. A few patients had to be hospitalized. However, these side effects affected each group about equally.

When all was said and done, the researchers determined that you can safely start taking vitamin B12 the same day you start taking pemetrexed chemotherapy for mesothelioma.