Study of Pemetrexed in Mesothelioma and Lung Cancer Patients With Fluid Around the Lungs or Abdomen

• This study will evaluate the safety and pharmacokinetics of pemetrexed in patients with third-space fluid. This outcome will be fully evaluated once the last patient receiving study treatment has discontinued from study treatment.
• Secondary: This study will identify increases in the toxicity of pemetrexed, assess the clinical relevance of any alterations in pemetrexed pharmacokinetics and provide pemetrexed dosing recommendations, in patients with third-space fluid.

• Number of Participants With Common Toxicity Criteria - National Cancer Institute Grade 3 and Grade 4 Toxicities [ Time Frame: baseline, up to 18 weeks ] [ Designated as safety issue: Yes ]

  Number of participants with laboratory and non-laboratory toxicities possibly related to study drug, which were graded using the Common Terminology Criteria for Adverse Events version 3.0 (CTCAE v3.0) for defining and grading specific adverse events. Grades range from 0 (none) to 5 (death). Grade 3 is severe and Grade 4 is life-threatening.

  NOS = Not otherwise specified.

• Pemetrexed Population Pharmacokinetics (PK): Clearance [ Time Frame: Cycle 1 and Cycle 2: before the end of infusion (approximately 9.5 minutes), 2 hours, 9-10 hours, 24-48 hours, 480-528 hours (20 to 22 days) after start of pemetrexed infusion ] [ Designated as safety issue: Yes ]
  Clearance (CL) can be defined as the volume of plasma which is completely cleared of drug (pemetrexed) per unit time. Total body clearance is calculated after intravenous administration of the drug (pemetrexed) and is measured by taking plasma samples at various timepoints and measuring the amount of pemetrexed in the plasma.
• Pemetrexed Population Pharmacokinetics: Volume of Distribution [ Time Frame: Cycle 1 and Cycle 2: before the end of infusion (approximately 9.5 minutes), 2 hours, 9-10 hours, 24-48 hours, 480-528 hours (20 to 22 days) after start of pemetrexed infusion ] [ Designated as safety issue: Yes ]
  Volume of distribution is the theoretical size of the compartment necessary to account for total drug amount in the body if it were present throughout the body in the same concentration found in plasma. Volume of distribution is defined as distribution of pemetrexed in the body and is determined by volume of distribution = dose/drug concentration. By knowing dose and measuring concentration of pemetrexed in plasma, volume was calculated. Central volume (V1) was determined by dose/peak serum level of pemetrexed. Peripheral volume (V2) is sum of all tissue spaces outside the central compartment.
• Discontinuations Due to Adverse Events [ Time Frame: baseline, up to 18 weeks ] [ Designated as safety issue: Yes ]
  Adverse events were coded using the Medical Dictionary for Regulatory Activities, Version 11.0.

This study will test the effects of pemetrexed on mesothelioma and non-small cell lung cancer patients with fluid around their lungs or abdomen.

• Non-small Cell Lung Cancer
• Mesothelioma
• Lung Neoplasms

Inclusion Criteria:

• Diagnosis of locally advanced or metastatic (Stage III or IV at entry) non-small cell lung cancer (NSCLC) or mesothelioma
• Presence of third-space fluid (fluid around the lungs or abdomen).
• Eastern Cooperative Oncology Group Performance Status of 0 or 1.
• Prior anticancer treatment (except radiation) must be completed at least 3 weeks prior to study enrollment, and the patient must have recovered from the sharp toxic effects the anticancer treatment.
• Estimated life expectancy of at least 8 weeks.

Exclusion Criteria:

• Have received treatment within the last 30 days with a drug that was not a marketed product.
• Active infection that, in the opinion of the investigator, would not allow the patient to tolerate therapy.
• Pregnancy.
• Breast-feeding.
• Significant weight loss (that is, greater than or equal to 10% of body weight) over the 6 weeks before study entry.
• Brain metastases.