Raltitrexed (Tomudex) for Mesothelioma

Raltitrexed (Tomudex) is one of the newer drugs that we have to treat cancer. It works particularly well for bowel (colorectal) cancer. Some researchers feel there is promise for a regimen of raltitrexed and cisplatin in treatment of mesothelioma.

It is one of a group of drugs known as the anti-metabolites. Anti metabolites often stop cells making and repairing DNA. Cancer cells need to make and repair DNA in order to grow and multiply. Anti metabolites also stop normal cells working properly. This is why they cause side effects.

Tomudex is administered by injection into the bloodstream.

Common Side Effects of Tomudex

Many people have one or more of the following side effects

• Fatigue - patients say this is the most disruptive side effect of all. Tiredness often carries on after treatment has ended. Most people find their energy levels are back to normal from 6 months to a year after their treatment finishes.
• Feeling or being sick
• Diarrhoea can start a few days after the chemotherapy. Occasionally this can become severe. You should see your doctor straight away if you have diarrhoea.
• Temporary drop in bone marrow function causing
  • Drop in white blood cell count. This increases the risk of bacterial infection. You may have headaches, aching muscles, cough, sore throat, pain when passing urine or feel cold and shivery. Infections can sometimes be life threatening. You should urgently contact your doctor if you think you have an infection
  • Drop in red cell count (anaemia), which may make you feel tired and look pale or be short of breath. You may need a blood transfusion or treatment to bring up your red cell count.
  • Drop in platelet numbers in the blood causing bleeding or bruising. You may have lots of tiny red spots or bruises on your arms or legs. You may have nosebleeds or bleeding gums.

  Contact your hospital if you have any of these bone marrow side effects.

• Mouth sores and ulcers - including sore throat and difficulty in swallowing
• Mild loss of appetite
• Mild effect on the liver. You are unlikely to notice any symptoms from this. And the liver function will almost certainly go back to normal when treatment is finished. To be on the safe side, your doctor will keep and eye on how your liver is working with blood tests called liver function tests.
• Skin rashes which may be itchy
• Tiredness and weakness
• This drug can have a harmful effect on a baby developing in the womb. It is not advisable to become pregnant or father a child whilst on chemotherapy. You should talk to your doctor about contraception before beginning treatment.

Some people have constipation and hair thinning.

Not everyone will get these side effects. You may have none or several. A side effect may get worse through your course of treatment, or more side effects may develop as the course goes on. This depends on

• How many times you've had the drug before
• Your general health
• How much of the drug you have (the dose)
• The way you take the drug (tablets or drip)
• Other drugs you are having

Side effects may be worse in people with kidney damage. The dose of the drug may have to be reduced.

National Guideline Clearinghouse on palliative treatment of mesothelioma.

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This website is sponsored by Jonathan David* of The David Law Firm. The David Law Firm is located in The Woodlands, Texas (Greater Houston Area) and can be reached toll free at 1-800-998-9729 for more information on mesothelioma. Jonathan David is not a medical doctor. The information on these pages is for the education of mesothelioma patients and their families regarding potential medical and legal options. Patients are advised to consult with a medical doctor.

*  Licensed by the Supreme Court  of Texas.

The use of chemotherapy in patients with advanced malignant pleural mesothelioma: a clinical practice guideline.

Advances in the systemic therapy of malignant pleural mesothelioma

Kinase Inhibitors for Mesothelioma Treatment

journal abstracts

Active symptom control with or without chemotherapy in the treatment of patients with malignant pleural mesothelioma (MS01): a multicentre randomised trial

The second wave in kinase cancer drugs

Cisplatin and vinorelbine first-line chemotherapy in non-resectable malignant pleural mesothelioma

Cytoreductive surgery and intraperitoneal chemotherapy for peritoneal mesothelioma.