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Alimta and cisplatin is the only drug combination approved by the FDA for the treatment of mesothelioma. Doctors consider it the standard chemotherapy treatment for this rare cancer.

The Most Successful Combination

Alimta and cisplatin are two chemotherapy drugs doctors use to treat mesothelioma. Each drug has shown marginal success as a treatment for mesothelioma on its own, but have produced even better results when doctors use them together.

The FDA approved the combination as a treatment for mesothelioma after a medical study demonstrated its effectiveness. The study showed that Alimta and Cisplatin successfully increased the life expectancy of patients by 3 months. Researchers in a more recent study, published in 2015, produced even better results. The combination of both drugs yielded a median survival rate of 1.6 years—a testament to how much doctors have improved it as a treatment.

While each drug attacks mesothelioma in a different way, both work together to stop the disease’s growth.


Alimta is an antifolate, an anti-cancer drug that blocks a mesothelioma cell’s ability to divide. Not allowing cancer cells to divide slows down a tumor’s metastasis, and helps to extend the survival time of patients with advanced stage mesothelioma.

Experts recommend Alimta for patients who meet the following criteria:

  • Advanced stage mesothelioma (stage three or stage four)
  • Doctors can’t surgically remove the tumor
  • Patients must be healthy enough to perform daily activities


Alimta was the first drug the FDA approved to treat mesothelioma. They designated it as an “orphan drug,” a term that means it’s approved for the treatment of rare diseases.


Cisplatin is a platinum-based anti-cancer drug approved by the FDA as a cancer treatment since 1978. While the FDA has approved Cisplatin as an anti-cancer drug for some time, they’ve only recently approved it to treat mesothelioma. It belongs to a class of chemotherapy drugs called alkylating agents, which works by attaching a special molecule—an alkyl group—onto the DNA of mesothelioma cells. The special molecule disrupts the internal processes of a mesothelioma cell, inducing apoptosis, the cell’s death.

Cisplatin is only marginally effective on its own, only producing a response rate of about 15 percent in clinical trials. A 15 percent response rate means the the drug shrunk a mesothelioma tumor in only 15 percent of the patients who received it as treatment.

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How Doctors Administer It

Doctors give Alimta to patients via slow intravenous (IV) drip over the course of 15 minutes. Cisplatin, however, takes longer to administer—just over 2 hours. A patient will receive both drugs over several sessions, each occurring once every 3 weeks for a few months. To reduce the severity of side effects, doctors make sure to include folic acid and vitamin B12 as part of the treatment. They typically give patients folic acid in pill form, and inject vitamin B12 one week before treatment begins, then once every 3 weeks during treatment.

How long treatment lasts depends on how a patient responds to Alimta and cisplatin. For example, if the side effects caused by the drugs become too much for a patient to handle, doctors may cut the treatment short, and consider substituting either Alimta or cisplatin for another drug.

Side Effects

Like most chemotherapy drugs, Alimta and cisplatin can cause side effects. When chemotherapy targets and attacks cancer cells, healthy cells are often damaged as well; their death is what actually causes side effects. Doctors have their patients take folic acid and B12 throughout the treatment process to lessen the impact of side effects.

Side effects caused by Alimta and Cisplatin include:

  • Nausea
  • Bruising or bleeding
  • Anemia
  • Diarrhea
  • Fatigue


Getting the Right Treatment

Alimta and cisplatin are used to effectively slow the growth of mesothelioma. However, despite its success, the combination may not be the right treatment option for everyone. Some patients react negatively to cisplatin, prompting doctors to replace it with another, similar chemotherapy drug, like carboplatin.

Only a doctor with experience treating mesothelioma—a rare cancer—can review your diagnosis and make sure you’re getting the right treatment. Contact a member of our Patient Help Team for free assistance with connecting to a doctor, getting treatment, or even finding financial aid to pay for it.

You can also learn more about your treatment options, and how to improve your prognosis, in our free informational guide. Order a free copy today and get started on improving your prognosis.