Specialists from the medical and legal profession providing care and support for the individuals diagnosed with the asbestos related cancer, mesothelioma, have united to express concern about the NICE decision to restrict availability of ALIMTA. Mesothelioma is a tumour affecting the membrane around the lungs, the heart or in some cases the abdomen.

It is usually associated with exposure to asbestos. Mesothelioma is a particularly difficult cancer to treat and surgery is ineffective in its control.

ALIMTA, used in association with Cisplatin, has been the subject of a number of clinical trials. It is the preferred treatment for mesothelioma in the US and most of Europe. It is thought that ALIMTA works by blocking specific enzymes believed to play a role in the rapid growth of this type of tumour.

ALIMTA cannot cure mesothelioma but in trials it was shown to improve life expectancy.

This is particularly important because life expectancy following diagnosis of mesothelioma is rarely more than 18 months. ALIMTA, produced by Eli Lilly, is the first and only chemotherapy drug to be approved by the United States Food and Drug Administration for the treatment of malignant pleural mesothelioma.

The drug has been considered by NICE (National Institute for Health and Clinic Excellence) in the UK.

NICE has decreed that the cost of treating with mesothelioma is too great and its advantages are too short lived for patients to be given the treatment.

It has recommended that it is only prescribed as part of an ongoing clinical trial and not simply for treatment purposes. Howard Bonnett, a lawyer specialising in asbestos disease claims at York based Solicitors, Corries Solicitors Ltd, expressed concern at the NICE decision.

He said “Mesothelioma is a devastating and aggressive cancer. Increasingly we see it affecting individuals in their forties and fifties.

Denying these individuals a treatment that could buy them several months may be denying them a chance to spend time with their children or grandchildren.

The cost of ALIMTA is not significant (particularly when compared with other drugs (such as Herceptin recently approved for breast cancer use).

The reality is that the majority of individuals diagnosed with mesothelioma have come into contact with asbestos at work. Many worked in the former nationalised industries.

Having been condemned to an early death by that employment they are now being denied the help, and hope that they need and deserve.”

Dr Thomas Stuttaford raised the issue in an article in The Times on June 30th 2006.

He made a point that “It is only by using drugs that they become cheaper and better understood. Pemetrexed (ALIMTA) was shown to have anti cancer properties as recently as 2000; time may prove that it is useful for other cancers, such as those of the colon, head and neck. Many of those now dying developed the disease because they or their relatives were in jobs of national importance before the dangers of asbestos were realised.

Society owes them a particular debt”. The national picture with regard to ALIMTA treatment is patchy. Health Chiefs in Plymouth have said that they will retain the option of using ALIMTA treatment where they believed it was appropriate. Dr Paul Hardy, of Plymouth Primary Care Trust, said

“We at Plymouth PCT tend to go along with NICE’s advice. But if a patient is currently taking the treatment I would be surprised if this recommendation affected the current patient management.”