The case of a German man who has lived more than 9 years with malignant mesothelioma is bringing attention to the drug that may have helped him defy the odds.
Mesothelioma is an aggressive malignancy of the pleural, peritoneal or pericardial membranes. It is most closely associated with occupational or environmental exposure to the toxic mineral asbestos and has a median survival of just 12 months after diagnosis. But the 67-year-old former German asbestos worker who is the subject of a new published report has stable mesothelioma, almost a decade after his initial examination.
Writing on the case in the medical journal Onco Targets and Therapy, doctors at the University of Essen say the patient was diagnosed with mesothelioma after a CT evaluation revealed a mass and thickening on the right side of the pleural lining around the lungs. The patient was treated with a combination of chemotherapy medications including an oral medication called etoposide and an injectable drug called paclitaxel.
Along with these drugs, the mesothelioma patient was also given pegylated liposomal doxorubicin hydrochloride by injection. Classified as an anthracycline, doxorubicin has the ability to interrupt communication within a cell’s DNA and prevent replication. According to the National Cancer Institute, liposomal delivery of doxorubicin HCL “improves drug penetration into tumors and decreases drug clearance”, which can increase the length of time that the drug will be effective in the body. A liposomal formulation of doxorubicin has also been shown to help make drug less toxic to the heart.
When the German patient had completed his chemotherapy, radiologic evaluation showed that the thickening caused by mesothelioma on his pleural lining had decreased and his symptoms had improved. While the researchers note that the patient’s follow-up is ongoing, regular CT scans indicate that his mesothelioma has not progressed in nine years.
Today, the gold standard for mesothelioma chemotherapy treatment in the U.S. is usually a combination of pemetrexed and a platinum-based drug such as cisplatin. Regardless of the chemotherapy regimen used, the new report suggests that doxorubicin HCL, particularly when delivered in a liposomal form, may have the ability to improve its effectiveness.