The standard chemotherapy treatment for malignant pleural mesothelioma is cisplatin and pemetrexed. Another chemo regimen used in the U.S. and other countries is the combination of cisplatin and gemcitabine. A recent study performed at the Athens University School of Medicine in Greece examined if the chemotherapy combination – gemcitabine plus docetaxel – were more or less effective than the two standard regimens. The reason for the study, according to the authors, was that this combination has not been investigated in mesothelioma before.
Gemcitabine (marketed as Gemzar) is used in various cancers including: non-small cell lung cancer, pancreatic cancer, bladder cancer and breast cancer. Docetaxel (marketed under the name Taxotere) is an anti-mitotic chemotherapy used mainly for the treatment of breast, ovarian, and non-small cell lung cancer.
The researchers enrolled twenty-five patients with malignant pleural mesothelioma. Each received 80 mg/m of docetaxel and 1,000 mg/m of gemcitabine on days 1 and 14 of a 28-day cycle. The treatment was scheduled for a maximum of six cycles or until the mesothelioma spread or there was too much toxicity for the patients.
A total of seven out of our 25 patients (28%) responded to treatment which means that for these seven patients their tumors decreased in size. In 14 patients (56%), the disease remained stable (did not grow or regress), while in 4 (16%) their cancers became worse. The overall survival ranged from 12.4-17.5 months with a median survival of 15 months. Although these results were not too impressive the authors concluded that “the administration of gemcitabine and doctaxel appears to be promising first-line therapy for patients with mesothelioma, as it is well tolerated and appears to improve survival.”
Ralli M, et al., Docetaxel plus gemcitabine as first-line treatment in malignant pleural mesothelioma: a single institution phase II study. Anticancer Res. 2009 Aug;29(8):3441-4.