A new study suggests that a treatment called isolated thoracic perfusion could help alleviate some of the worst symptoms of malignant pleural mesothelioma.
Isolated thoracic perfusion is a method for circulating medicine in just one area of the body. When doctors circulated chemotherapy drugs in the chests of people with pleural mesothelioma, their symptoms went away for several months.
Now, the team says it is time to test the technique in a bigger pool of mesothelioma patients.
The Theory Behind ITP
Pleural mesothelioma is a membrane cancer that occurs in the chest. Chemotherapy drugs like Alimta can be powerful weapons against pleural mesothelioma. But they can also damage healthy tissues.
When healthy tissues are damaged by chemotherapy, mesothelioma patients can develop serious side effects. Some side effects of chemotherapy may even be fatal.
Isolated thoracic perfusion is a method for keeping chemotherapy drugs in just one area. The theory is that if these drugs only circulate where they are needed, they will do less damage. Less damage to healthy tissue means fewer mesothelioma treatment side effects.
Testing Isolated Thoracic Perfusion for Mesothelioma
To keep medicine in the chest, doctors have to create a closed circulation loop. With the patient asleep, they temporarily block off some arteries with tiny balloons. They may also put tight cuffs around the arms.
Medicine flows through the circulatory system in the chest for a few minutes. Then the medicines are filtered out, the balloons are removed, and regular circulation resumes.
Results of the New ITP Study
The latest test of isolated thoracic perfusion focused on mesothelioma patients who failed with regular chemotherapy. These 52 patients received treatment between 2000 and 2017.
Only 8 percent of the patients had significant side effects from ITP. These had to do with white blood cell counts and neurological issues. They were not considered severe.
A quarter of the mesothelioma tumors responded to isolated thoracic perfusion. It took a median of 7 months for patients’ tumors to start growing again after treatment. Some patients had additional treatments afterward. The median overall survival after ITP was 16 months.
People with epithelioid mesothelioma responded better than those with non-epithelioid subtypes. The same was true for patients whose cancer was at Stage I or II.
The treatment is not a cure for mesothelioma. But researchers conclude that isolated thoracic perfusion is “safe, tolerable and useful.” They are calling for more studies of ITP to find out if it should be a routine part of palliative care for mesothelioma.
“Its inclusion in the multidisciplinary palliative treatment of progressive MPM patients should be investigated in a larger multicentre controlled study,” they write.
A similar study in 2017 produced similar results. Those patients experienced progression-free mesothelioma survival of 9 months with no serious toxicity.
Guadagni, S, et al, “Multidisciplinary palliative treatment including isolated thoracic perfusion for progressive malignant pleural mesothelioma: a retrospective observational study”, May-June 2019, Journal of the Balkan Union of Oncology, https://www.ncbi.nlm.nih.gov/pubmed/31424688
Aigner, KR, et al, “Isolated thoracic perfusion with chemofiltration for progressive malignant pleural mesothelioma”, June 2017, Oncotargets and Therapy, https://www.researchgate.net/publication/317679391_Isolated_thoracic_perfusion_with_chemofiltration_for_progressive_malignant_pleural_mesothelioma