Low-Dose Gemzar: Cost Effective Alternative for Mesothelioma?

A new study of an alternative form of chemotherapy for mesothelioma finds that it may be a safe, effective, and less expensive treatment option, especially for low-income patients.

Gemzar (gemcitabine) is a nucleoside analog that has been found to arrest tumor growth and trigger apoptosis (cell death)in several types of cancer, including breast, bladder, pancreatic and non-small cell lung cancer. Now, researchers working on a phase II trial of Gemzar for advanced malignant pleural mesothelioma say a continuous low-level infusion of the drug may be a viable treatment option.

Dr. Oscar Arrieta and colleagues at the National Cancer Institute of Mexico evaluated the outcomes of 39 patients with advanced mesothelioma treated with low-dose infusions of Gemzar and cisplatin instead of the standard mesothelioma regimen of Alimta (pemetrexed) and cisplatin. The median survival for mesothelioma patients receiving the continuous low-dose Gemzar infusions was 20.7 months, with the longest-living patient surviving for more than 2-and-half years after treatment.

More than half (53.8%) of the mesothelioma patients saw a partial response to the Gemzar treatment, meaning their mesothelioma tumors shrunk somewhat, and a third of patients experienced a stabilization of their mesothelioma. Low-dose Gemzar did not work for 12.8% of the patients whose mesothelioma tumors continued to grow in spite of the treatment.

Mostly importantly, however, most of the mesothelioma patients on Gemzar experienced a significant improvement in their quality of life. “The functional, physical and emotional roles and dyspnea [shortness of breath], insomnia and pain symptom scales improved,” reports Dr. Arrieta in Cancer Chemotherapy and Pharmacology. The most common serious side effects with low-dose Gemzar therapy involved reductions in certain types of white blood cells and anemia.

The Mexican researchers conclude that low-dose, prolonged Gemzar/cisplatin therapy “has acceptable toxicity and high efficacy with improved quality of life” for mesothelioma patients. Because Gemzar costs less that Alimta, the team further concluded that the approach represents a more affordable regimen for patients.

Source:

Arrieta, O et al, “A phase II trial of prolonged, continuous infusion of low-dose gemcitabine plus cisplatin in patients with advanced malignant pleural mesothelioma”, April 1, 2014, Cancer Chemotherapy and Pharmacology, April 2014, Epub ahead of print