| | | | | | |

Additional Chemotherapy Extends Survival in Relapsed Mesothelioma Patients

ByAlex Strauss

Black American PatientMesothelioma patients who experience a recurrence of their asbestos cancer after radical surgery may live longer if they undergo additional rounds of chemotherapy.

That conclusion comes from a group of Japanese researchers who performed a retrospective review of 59 consecutive pleural mesothelioma patients who had multimodal mesothelioma treatment that included extrapleural pneumonectomy (EPP) surgery.

Study subjects had been treated for malignant mesothelioma at Hyogo College of Medicine between July 2004 and August 2013. Patients received mesothelioma chemotherapy prior to surgery and some also received radiation therapy afterward.

Second-Line Treatment and Mesothelioma Survival

There is no universally-accepted second-line therapy for people whose malignant mesothelioma comes back after first-line treatment. Numerous studies have been conducted in an effort to find the most effective way to re-treat these relapsed patients.

In the new Japanese study, 39 of the 59 mesothelioma patients eventually relapsed after their EPP surgery. The median time to relapse was a little less than a year. Of the patients who relapsed, 27 had undergone just one other treatment modality in addition to surgery while 12 had undergone all three types of treatment.

Chemotherapy After Surgery

In many cases, mesothelioma patients who relapse after aggressive treatment are told that they have no other treatment options and are recommended for palliative care and/or hospice.

That was the situation in 12 of the cases that were reviewed for the new study. Six other patients started chemotherapy after surgery but discontinued it. The remaining 21 (53%) mesothelioma patients completed more than three cycles of systemic chemotherapy. These are the patients who had the best survival results.

“The median survival time after EPP was significantly longer in 21 patients who received additional chemotherapy than in 18 patients who did not,” says Dr. Teruhisa Takuwa with the Department of Thoracic Surgery at Hyogo College of Medicine.

According to the report published in the International Journal of Clinical Oncology, the mesothelioma patients who stuck with the additional chemotherapy had a median survival of 39.2 months after their EPP surgery. In contrast, the 18 patients who did not complete the additional treatment had a median survival of just 12.2 months.

The researchers conclude that there is clearly a survival benefit to undergoing additional chemotherapy after EPP if mesothelioma recurs.

Approximately 2,500 people are diagnosed with mesothelioma in the US each year, usually as a result of asbestos exposure. Most are treated with a combination of therapies including chemotherapy with pemetrexed (Alimta) and cisplatin.

Patients with good overall health may be recommended for either EPP surgery, during which a lung is removed, or lung-sparing pleurectomy/decortication (P/D). Mesothelioma experts remain divided over which surgical approach is preferable since EPP carries a higher rate of complications and death, but may offer a better chance at longer survival.

Source:

Takuwa, T, et al, Post-recurrence chemotherapy for mesothelioma patients undergoing extrapleural pneumonectomy”, April 24, 2017, International Journal of Clinical Oncology, Epub ahead of print

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…