# Phase 3 trial of pemetrexed plus cisplatin versus cisplatin alone in malignant pleural mesothelioma

Source: https://onco.cc/key-papers/paper-vogelzang-pemetrexed-mesothelioma-jco-2003/  
OnCo record `paper-vogelzang-pemetrexed-mesothelioma-jco-2003` (Key paper). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Adding pemetrexed to cisplatin lengthened survival by almost three months in pleural mesothelioma, making platinum-pemetrexed the first, and for many years the only, standard chemotherapy for the disease.

## Summary

Phase 3 trial of 456 chemotherapy-naive patients with malignant pleural mesothelioma randomised to pemetrexed plus cisplatin or cisplatin alone, with folic acid and vitamin B12 supplementation introduced part-way through to reduce toxicity.

Median overall survival was 12.1 versus 9.3 months, response rate 41.3 versus 16.7 percent, and lung function and symptoms were better with the combination; vitamin supplementation markedly reduced severe toxicity.

## Fields

- Kind: Key paper
- Last checked: 2026-09-17
- Journal: Journal of Clinical Oncology
- Year: 2003
- DOI: 10.1200/JCO.2003.11.136
- Authors: Vogelzang NJ, Rusthoven JJ, Symanowski J, et al.
- Findings: Median overall survival 12.1 vs 9.3 months.; Objective response 41.3 percent vs 16.7 percent.
- What it means: Platinum-pemetrexed remains the chemotherapy backbone in mesothelioma, now combined with pembrolizumab or bevacizumab, or replaced by dual immunotherapy in non-epithelioid disease.
- Caveats: Single-agent cisplatin comparator.; Vitamin supplementation changed mid-trial.

## Sources

- J Clin Oncol 2003: https://doi.org/10.1200/JCO.2003.11.136
- PubMed: https://pubmed.ncbi.nlm.nih.gov/12860938/

## Connected records

- cancers: [Peritoneal mesothelioma](https://onco.cc/cancers/peritoneal-mesothelioma/), [Pleural mesothelioma](https://onco.cc/cancers/pleural-mesothelioma/)
- drugs: [Cisplatin](https://onco.cc/drugs/cisplatin/), [Pemetrexed](https://onco.cc/drugs/pemetrexed/)
- journals: [Journal of Clinical Oncology](https://onco.cc/journals/jco/)

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