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Calculation of Carboplatin Dose
Mesothelioma


Cisplatin + Pemetrexed

Cisplatin (CDDP) 75 mg/m2 iv over 2 hours d1 30 min after pemetrexed
Pemetrexed (Alimta) 500 mg/m2 iv over 10 min d1
Q3w

Start vitamin supplements 1 week before initial dose of pemetrexed until 21 days after last dose of pemetrexed. Folic acid 350-1000 mcg po qd. Vitamin B12 1000 mcg I.M. every 9 weeks.
Dexamethasone (Decadron) 4 mg twice daily the day before, the day of and the day after pemetrexed

Vogelzang, NJ et al. Phase III study of pemetrexed in combination with cisplatin versus cisplatin alone in patients with malignant pleural mesothelioma. J Clin Oncol 2003; 21:2636 (link to the article).

Carboplatin + Pemetrexed
Carboplatin (Paraplatin) AUC 5 iv over 30 min d1 30 min after pemetrexed
Pemetrexed (Alimta) 500 mg/m2 iv over 10 min d1
Q3w

Start vitamin supplements 1 week before initial dose of pemetrexed until 21 days after last dose of pemetrexed. Folic acid 350-1000 mcg po qd. Vitamin B12 1000 mcg I.M. every 9 weeks.
Dexamethasone (Decadron) 4 mg twice daily the day before, the day of and the day after pemetrexed 

Ceresoli GL et al. Phase II study of pemetrexed plus carboplatin in malignant pleural mesothelioma. J Clin Oncol 2006; 24:1443 (link to the article).

Pemetrexed
Pemetrexed (Alimta) 500 mg/m2 iv over 10 min d1 q3w 

Start vitamin supplements 1 week before initial dose of pemetrexed until 21 days after last dose of pemetrexed. Folic acid 350-1000 mcg po qd. Vitamin B12 1000 mcg I.M. every 9 weeks.
Dexamethasone (Decadron) 4 mg twice daily the day before, the day of and the day after pemetrexed

Scagliotti GV et al. Phase II study of pemetrexed with and without folic acid and vitamin b12 as first-line therapy in malignant pleural mesothelioma. J Clin Oncol 2003; 21:1556 (link to the article). 

Jassem J et al. Phase III trial of pemetrexed plus best supportive care compared with best supportive care in previously treated patients with advanced malignant pleural mesothelioma. J Clin Oncol 2008; 26:1698 (link to the article).