For Some Patients Chemo Cuts Mesothelioma Survival

Asbestos disease researchers in Australia say chemotherapy at the end of life may be doing some mesothelioma patients more harm than good.

The team from the Asbestos Diseases Research Institute in Rhodes, Australia analyzed the cases of 147 malignant pleural mesothelioma patients who had received compensation from the government’s Dust Diseases Board. The focus of the study was to determine the association between a variety of factors such as age, gender, geographic location, disease stage, histological subtype, length of first-line chemotherapy, and the use of chemotherapy in the last month of their lives.

Among the mesothelioma patients studied, most (77%) received more than one treatment modality while 56% received only one. Chemotherapy, which continues to be the most popular first-line treatment for mesothelioma, was used in the treatment of 78 patients. Fifty patients had radiotherapy for their mesothelioma and 116 had surgery. Twenty-one of the mesothelioma patients received treatment in their last month of life, including nine who had chemotherapy. The researchers found that patients who had already been treated at least twice with chemotherapy – especially if they failed to show a response – were more likely to have it again in the last month of their lives.

But, although chemotherapy has had some success with improving survival when given at earlier stages of mesothelioma, the Australian study suggests that it may have the opposite effect in late-stage patients. In a newly-published article on their findings, they report that “Patients who received chemotherapy at the end of life had shorter survival compared to those who did not receive chemotherapy at the end of life.”

In fact, the mesothelioma patients whose doctors were still trying chemotherapy in their last weeks of life survived for an average of 5.3 months as compared to those who did not have chemotherapy at this last stage.  The survival average for this group was 12.5 months. The findings suggest that these non-responders not only received no additional benefit from a last attempt at chemotherapy treatment, but may even have died sooner because of the additional physical stress it caused. Based on these findings, the researchers recommend that clinicians give “more careful consideration of when to cease chemotherapy” in the treatment of mesothelioma.

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