Mesothelioma patients who’ve heard about chemotherapy drug shortages affecting cancer centers nationwide may worry about its impact on their treatment, but there’s nothing to fear: mesothelioma care has more built-in flexibility today than at any previous point in the history of treating this rare and challenging asbestos-related cancer.
Mesothelioma Treatment Offers a Choice Between Two Platinum Chemotherapy Drugs
The standard first-line chemotherapy treatment for pleural mesothelioma combines pemetrexed with either cisplatin or carboplatin, and that “either/or” design turns out to be exactly the kind of flexibility that has helped cancer centers manage platinum drug shortages in the past. When cisplatin supplies run low, oncologists can shift mesothelioma patients to carboplatin, and vice versa, without moving away from approved, guideline-sanctioned treatment. During the 2023 platinum drug shortage, cancer centers (including those treating mesothelioma patients) used this approach with great success, shifting patients toward whichever platinum drug was available.
Beyond having flexibility about which of these two chemotherapy drugs to use, mesothelioma patients now have good alternatives to platinum-based chemotherapy. Updated guidelines from the American Society of Clinical Oncology indicate three other first-line treatment paths for epithelioid mesothelioma that have similar effectiveness. In addition to chemotherapy with pemetrexed plus cisplatin or carboplatin, oncologists can prescribe immunotherapy with ipilimumab and nivolumab or a chemoimmunotherapy combination of pembrolizumab, pemetrexed, and carboplatin. The right choice depends on the patient’s histology, disease burden, other medical conditions, and preference.
Mesothelioma Patients Who Cannot Tolerate Platinum Have a Platinum-Free Path
Critically for mesothelioma patients concerned about drug shortages, the ipilimumab and nivolumab doublet immunotherapy regimen contains no platinum chemotherapy at all. This combination is already recommended for patients who can’t tolerate pemetrexed due to poor kidney function. This means there’s an entire decision pathway that continues mesothelioma care, even in the face of a platinum drug shortage.
Today’s mesothelioma treatment landscape offers more pathways than ever before, giving your care team several good options regardless of what happens with drug supply chains. If an individual mesothelioma treatment center is facing platinum constraints, alternatives include prioritizing whichever platinum drug is in stock, adjusting dosing within approved ranges, modifying treatment timing, or shifting eligible patients toward the immunotherapy-only combination rather than a platinum-containing chemotherapy regimen. None of these adjustments requires stepping outside established treatment guidelines.
If you or someone you love has been diagnosed with mesothelioma and treatment is about to begin, having an open conversation with your oncologist about whether shortages will impact your treatment path makes sense. For more information on treatment options, expert care, and other resources, contact the Patient Advocates at Mesothelioma.net today at 1-800-692-8608.
