Pleural malignant mesothelioma, which affects the tissue that surrounds the lungs and is the most common form of mesothelioma. Pleural malignant mesothelioma originated from pleural mesothelium cell, is an fatal tumor with natual history of only about several months, has showed an increased morbidity recently. One of diffuse malignant mesothelioma of the chest tumor one of the worst prognosis. diffuse malignant mesothelioma is often treated with surgery and chemotherapy. Pemetrexed disodium is the only agent for the treatment of malignant pleural mesothelioma(MPM). Pemetrexed is a targeted therapy drugs. Pemetrexed is a novel anti-neoplastic agent of multitargeted antifolate in the treatment of malignant tumors.Malignant pleural mesothelioma is a rare progressive chest cancer, About 5 percent of tumor of the pleura, the survival rate is 5 - 11 months. The incidence of mesothelioma is related to asbestos exposure. The pathogenesis of malignant mesothelioma is asbestos expos ure. Asbestos fibers are inhaled into the chest, and then Asbestos fibers deposited in the pleural in the form of the spots. Parietal pleura is a disease site. Malignant mesothelioma is a likely worsening of the disease. It is already advanced cancer when the people are diagnosed with mesothelioma. Treatment of surgery, radiotherapy is not very satisfactory. The treatment of malignant pleural mesothelioma is still the main medical treatment, but efficacy and survival is limited.
Pemetrexed is a multitargeted antimetabolite that has shown activity in malignant pleural mesothelioma and NSCLC, which has been approved in more than 70 countries. it is a multi-target folate antimetabolite, mainly inhibit thymidylate synthase (TS), while suppressing the extra folic acid dependent enzymes such as dihydrofolate reductase (DHFR) and GLYCINAMIDE nucleotide switch Formyl enzyme (GARFT). the efficacy of pemetrexed plus cisplatin for patients with malignant pleural mesothelioma. Methods: All 36 patients with malignant pleural mesothelioma were treated by 4 cycles of pemetrexed plus cisplatin. Of the 36 patients there were 24 males and 12 females, the average age was 46.3 2. 6 years. Results: Of all 36 patients, the overall response rate was 55.6 percent, 20 cases received partial remission?no case received complete remission. The major toxicity was nausea and vomit. Only one patient had myelosuppression. Conclusion: Pemetrexed plus cisplatin is a safe and effe ctive regimen in malignant pleural mesothelioma.
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