Mesothelioma Therapy Chemotherapy for Mesothelioma 1 — Questions and Answers
Question 1: What is the standard first-line chemotherapy regimen for unresectable pleural mesothelioma?
- Gemcitabine + Carboplatin
- Pemetrexed + Cisplatin (Correct answer)
- Doxorubicin + Cyclophosphamide
- Paclitaxel + Carboplatin
Correct answer: Pemetrexed + Cisplatin
Pemetrexed combined with cisplatin is the FDA-approved standard first-line chemotherapy regimen for unresectable pleural mesothelioma.
Question 2: Which vitamin supplements are required for patients receiving pemetrexed to reduce toxicity?
- Vitamin A and D
- Folic acid and vitamin B12 (Correct answer)
- Vitamin C and zinc
- Vitamin E and selenium
Correct answer: Folic acid and vitamin B12
Folic acid and vitamin B12 supplementation are mandatory for patients on pemetrexed to reduce hematologic and gastrointestinal toxicity.
Question 3: What is pemetrexed's primary mechanism of action?
- DNA alkylation
- Microtubule stabilization
- Antifolate—inhibits multiple folate-dependent enzymes (Correct answer)
- Topoisomerase inhibition
Correct answer: Antifolate—inhibits multiple folate-dependent enzymes
Pemetrexed is an antifolate agent that inhibits multiple folate-dependent enzymes essential for DNA synthesis, thereby halting cancer cell replication.
Question 4: Carboplatin is sometimes substituted for cisplatin in mesothelioma chemotherapy for which reason?
- Greater efficacy
- Better tolerability in patients with renal dysfunction (Correct answer)
- Lower cost only
- Availability in oral form
Correct answer: Better tolerability in patients with renal dysfunction
Carboplatin is substituted for cisplatin primarily due to better tolerability, especially in patients with renal impairment or those who cannot tolerate cisplatin's toxicity.
Question 5: What is the typical number of cycles for first-line pemetrexed + cisplatin chemotherapy in mesothelioma?
- 2–3 cycles
- 4–6 cycles (Correct answer)
- 8–10 cycles
- 12 cycles
Correct answer: 4–6 cycles
Standard first-line chemotherapy for mesothelioma typically consists of 4–6 cycles of pemetrexed + cisplatin.
Question 6: Which second-line chemotherapy agent has shown activity in previously treated mesothelioma?
- Oxaliplatin
- Gemcitabine (Correct answer)
- Bleomycin
- Methotrexate
Correct answer: Gemcitabine
Gemcitabine has demonstrated modest activity as a second-line therapy in patients with previously treated mesothelioma.
Mesothelioma Therapy Chemotherapy for Mesothelioma 1
What is the standard first-line chemotherapy regimen for unresectable pleural mesothelioma?