| | | | | |

Study Reveals Mesothelioma Chemotherapy May Be Underused in Older Patients

ByAlex Strauss

mesothelioma chemotherapy treatmentThe older a mesothelioma patient is, the less likely he or she may be to receive mesothelioma chemotherapy. A new study says many older mesothelioma sufferers may be paying the price in shorter lifespans.

Chemotherapy with pemetrexed (Alimta) and cisplatin is the gold standard for mesothelioma treatment. Many studies have linked it with longer mesothelioma survival.

But an Australian study suggests that not enough older people are receiving mesothelioma chemotherapy.

In fact, the older they are, the less likely they are to have chemotherapy for their mesothelioma. As a result, their chances of dying from malignant mesothelioma are higher.

Mesothelioma Chemotherapy is Standard of Care

Malignant mesothelioma is a hard-to-treat cancer with a poor prognosis. Mesothelioma chemotherapy is the primary way oncologists try to help extend survival.

Most patients undergo other treatments along with mesothelioma chemotherapy. These might include surgery, intrapleural chemotherapy, radiation, or immunotherapy.

But there is one group of mesothelioma patients who are not getting the benefits of mesothelioma chemotherapy as often as they could be. Others may be receiving chemotherapy when it could do more harm than good.

Analyzing Chemotherapy Use Among Mesothelioma Patients

Australia was once a major global producer of asbestos and now has one of the highest per capita rates of asbestos cancer in the world.

Researchers with Australia’s Asbestos DIseases Research Institute in Sydney conducted the new study. It included 910 mesothelioma patients. Forty-one percent of the patients were younger than 70. Forty percent were between 70 and 80. The final 19 percent were over 80.

The study found that the median overall mesothelioma survival rate in these patients decreased as they got older, as did chemotherapy use.

Mesothelioma Chemotherapy and Survival

Only 66 percent of patients under 70 received mesothelioma chemotherapy. That group had a median survival of 13.5 months. The rate of chemotherapy dropped to just 35 percent in mesothelioma patients between 70 and 80. Survival in this group was 9.5 months.

Among mesothelioma patients over 80, only 8 percent received chemotherapy. Their median overall survival was just 7.1 months.

“A Kaplan Meier analysis revealed that there was a significant survival advantage for patients under 70 and 70 to 80 years receiving chemotherapy, but not for patients over 80 years,” writes author Anthony Linton.

Patients under 70 who did receive chemotherapy had a survival rate of 16.8 months. Patients in the same age group who did not have mesothelioma chemotherapy had a median survival of just 7 months.

A similar difference was observed in the 70 to 80 year old group. With mesothelioma chemotherapy, those patients lived for a median of 13.9 months. Without it, survival dropped to just 5.8 months. Patients over 80 did not live longer with chemotherapy.

The authors do not explore why there is a difference in chemotherapy use in older patients. They conclude that more study is needed to determine whether the current treatment guidelines are relevant for the oldest mesothelioma patients.

Source:

Linton, A, et al, “Patterns of care and survival of older patients with malignant pleural mesothelioma”, March 24, 2019, Journal of Geriatric Oncology, Epub ahead of print, https://www.geriatriconcology.net/article/S1879-4068(18)30425-9/fulltext

Similar Posts

  • | |

    Doctors Describe "Concrete Therapeutic Approach" for Mesothelioma

    ByAlex Strauss

    A team of medical researchers in Italy have achieved what they are calling “excellent” tumor control and survival results in malignant pleural mesothelioma patients using a combination of surgery, chemotherapy, and radiotherapy. Caused by exposure to asbestos, mesothelioma typically spreads quickly across the lung-encasing membrane called the pleura. There is no known cure but treatments are improving. In the current prospective study, 20 malignant pleural mesothelioma patients underwent radical pleurectomy/decortication followed by high doses of radiation. After surgeons removed as much of the visible mesothelioma tumor and surrounding tissue as possible, patients received 50Gy of radiation to the effected side of their chest, delivered in 25 fractions. Regions of particular concern for mesothelioma regrowth got an extra radiation “boost” to…

  • |

    Mesothelioma Still Rising Despite Ban in Ireland

    ByAlex Strauss

    A study in Ireland confirms that it can take many years for a ban on asbestos to have a measurable impact on a country’s rates of malignant mesothelioma. Mesothelioma is the most serious of a list of diseases – including lung cancer, pleural plaques, asbestosis, and others – linked with exposure to asbestos dust. Affecting the linings around the lungs and other organs, mesothelioma is often resistant to most cancer treatments and may be fatal within a year of diagnosis. According to the International Ban Asbestos Secretariat, Ireland is one of 55 countries that have enacted some type of asbestos ban. However, although Ireland banned asbestos in 2000, a new study published in Cancer Epidemiology shows that incidence of the…

  • | |

    Does Radiotherapy Reduce Mesothelioma Pain?

    ByAlex Strauss

    A new study says there is not enough evidence to support the use of radiotherapy for the treatment of pain associated with malignant pleural mesothelioma. Researchers at the University of Edinburgh in Scotland reviewed a range of past studies on mesothelioma pain and radiotherapy by searching databases that date back as far as 1974. To be eligible to be included in their review, the study had to focus on malignant pleural mesothelioma and radiotherapy given “with the intent of improving pain”. The study also had to report doses and fractionation of the radiotherapy and how the pain responded. In all, the researchers found eight studies on mesothelioma pain and radiotherapy that met the criteria. Two of the studies were prospective…

  • |

    Website Aims to Protect Homeowners from Mesothelioma

    ByAlex Strauss

    Australia’s Cancer Council is trying to educate home renovators about their risk for mesothelioma with a new e-learning course. Australia has one of the highest per capita rates of mesothelioma in the world, largely because of several asbestos mining operations that were once located there. Although asbestos has been banned from building products in Australia since 1989, asbestos-linked diseases like mesothelioma, lung cancer, and asbestosis continue to pose a serious health concern. While mesothelioma has traditionally occurred among people exposed to asbestos on the job, Australia is now bracing for another “wave” of mesothelioma victims among homeowners who encounter asbestos while doing their own renovation projects. Cancer Council Australia has launched “kNOw asbestos in your home” in an effort to…

  • |

    Ape Virus Shrinks Mesothelioma Tumors in Lab

    ByAlex Strauss

    A virus that causes leukemia in gibbon apes may have the power to help fight malignant mesothelioma in people. Gibbon ape leukemia virus (GALV) has been tested for years as a viral vector, a carrier of therapeutic genetic information, in the treatment of various human illnesses, including cancer. A new study in Japan compared GALV with a leukemia virus derived from mice to see which carrier communicated most efficiently with mesothelioma cells. While both types of viruses replicated in most of the mesothelioma cell lines tested, the mouse-derived virus was not effective in a mesothelioma cell line called ACC-MESO-1. In this cell line, only the GALV spread efficiently both in culture and in mice that had been given human mesothelioma…

  • | |

    Radiotherapy for Mesothelioma: Better But Still Limited

    ByAlex Strauss

    A form of highly-targeted radiation therapy for mesothelioma is better than it used to be, but is still risky. That is the message of a recent article on intensity-modulated radiation therapy (IMRT) in Seminars in Thoracic and Cardiovascular Surgery. Author Kenneth E. Rosenzweig, MD, a Radiation Oncologist with Mount Sinai Hospital in New York, reviewed recent studies on IMRT and mesothelioma. He concludes that, while the “troubling toxicity” associated with IMRT when it was first introduced has not been entirely eliminated, the fact that clinicians now have more experience with it is making a positive difference for mesothelioma patients. Before targeted therapies like IMRT were available, high-dose radiation was not usually a feasible option for mesothelioma since the irregular shape…