| | | | |

Maintenance Therapy with Gemcitabine Extends Mesothelioma Survival in Dutch Study

ByAlex Strauss

maintenance therapyDutch researchers say administering maintenance therapy with gemcitabine after chemotherapy may help mesothelioma patients live longer than supportive care alone. 

Gemcitabine is an antimetabolite sold under the brand name Gemzar. Oncologists use it to treat several other types of cancer. When cancer cells absorb gemcitabine, they can no longer divide into new cancer cells. 

Most mesothelioma patients have chemotherapy as their first-line treatment. If they are healthy enough, they may also have mesothelioma surgery. A maintenance therapy is a treatment that follows the main treatment. It is an effort to maintain the effects of the treatment. 

The new Dutch study shows gemcitabine may be a safe and effective choice for maintenance therapy.

What Does Maintenance Therapy Mean?

Right now, there is no cure for mesothelioma. Patients who receive a mesothelioma diagnosis do not have many treatment options. Chemotherapy with Alimta is the primary or first-line mesothelioma treatment for most patients. It is usually combined with another drug called cisplatin. 

Unfortunately, this ‘gold standard’ mesothelioma therapy does not work for everyone. Previous studies suggest that chemotherapy alone extends mesothelioma survival by an average of four months. 

Maintenance therapy is a second-line treatment that is ongoing. Patients come back to the hospital at regular intervals to get the treatment. An effective maintenance therapy could prolong the effects of chemotherapy and extend mesothelioma survival. 

Testing Gemcitabine After Standard Chemotherapy

The new study was conducted by researchers at the Netherlands Cancer Institute in Amsterdam. It included 130 mesothelioma patients from 18 Dutch hospitals. Patients were diagnosed between 2014 and 2019 with unresectable mesothelioma. They had at least four rounds of chemotherapy with no additional mesothelioma progression.

Doctors randomly assigned each patient to one of two groups. The first group received maintenance therapy with gemcitabine along with standard supportive care. The second group had only supportive care. 

Patients on the maintenance therapy received 1250 mg/m2 of gemcitabine on days 1 and 8 in 21-day cycles. The treatment stopped if the patient had a severe reaction or if another serious illness came up. Patients could also request to stop.

Promising Results of the Gemcitabine Study

Researchers tracked both groups of mesothelioma patients for a median of three years. Across the board, those on maintenance therapy with gemcitabine had better survival. 

“Progression-free survival was significantly longer in the gemcitabine group (median 6·2 months) than in the supportive care group (3·2 months),” writes lead author Cornedine J de Gooijer.

But the treatment was not without complications. More than half of the patients on the maintenance therapy had serious (Grade 3 – 4) adverse events. Only 16 percent of the supportive care group had these kinds of problems. The most common problems were anemia, low white blood cells, fatigue, pain, or infection. One of the 65 mesothelioma patients in the gemcitabine group died. 

Still, researchers say the study is proof that Gemzar may help some mesothelioma patients live longer after chemotherapy. “This study confirms the activity of gemcitabine in treating malignant mesothelioma,” says Dr. de Gooijer. 

Other drugs and combinations that have been tested as second-line or maintenance therapy for mesothelioma include:

To date, none of these treatments has been shown to extend mesothelioma survival by more than eight months. 

Source:

De Gooijer, C, et al, “Switch-maintenance gemcitabine after first-line chemotherapy in patients with malignant mesothelioma (NVALT19): an investigator-initiated, randomised, open-label, phase 2 trial”, January 2021, Lancet Respiratory Medicine, Online ahead of print, https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(20)30362-3/fulltext

 

Similar Posts

Doctors Describe "Concrete Therapeutic Approach" for Mesothelioma
| |

Doctors Describe "Concrete Therapeutic Approach" for Mesothelioma

ByAlex Strauss

A team of medical researchers in Italy have achieved what they are calling “excellent” tumor control and survival results in malignant pleural mesothelioma patients using a combination of surgery, chemotherapy, and radiotherapy. Caused by exposure to asbestos, mesothelioma typically spreads quickly across the lung-encasing membrane called the pleura. There is no known cure but treatments are improving. In the current prospective study, 20 malignant pleural mesothelioma patients underwent radical pleurectomy/decortication followed by high doses of radiation. After surgeons removed as much of the visible mesothelioma tumor and surrounding tissue as possible, patients received 50Gy of radiation to the effected side of their chest, delivered in 25 fractions. Regions of particular concern for mesothelioma regrowth got an extra radiation “boost” to…

Mesothelioma Still Rising Despite Ban in Ireland
|

Mesothelioma Still Rising Despite Ban in Ireland

ByAlex Strauss

A study in Ireland confirms that it can take many years for a ban on asbestos to have a measurable impact on a country’s rates of malignant mesothelioma. Mesothelioma is the most serious of a list of diseases – including lung cancer, pleural plaques, asbestosis, and others – linked with exposure to asbestos dust. Affecting the linings around the lungs and other organs, mesothelioma is often resistant to most cancer treatments and may be fatal within a year of diagnosis. According to the International Ban Asbestos Secretariat, Ireland is one of 55 countries that have enacted some type of asbestos ban. However, although Ireland banned asbestos in 2000, a new study published in Cancer Epidemiology shows that incidence of the…

Does Radiotherapy Reduce Mesothelioma Pain?
| |

Does Radiotherapy Reduce Mesothelioma Pain?

ByAlex Strauss

A new study says there is not enough evidence to support the use of radiotherapy for the treatment of pain associated with malignant pleural mesothelioma. Researchers at the University of Edinburgh in Scotland reviewed a range of past studies on mesothelioma pain and radiotherapy by searching databases that date back as far as 1974. To be eligible to be included in their review, the study had to focus on malignant pleural mesothelioma and radiotherapy given “with the intent of improving pain”. The study also had to report doses and fractionation of the radiotherapy and how the pain responded. In all, the researchers found eight studies on mesothelioma pain and radiotherapy that met the criteria. Two of the studies were prospective…

Website Aims to Protect Homeowners from Mesothelioma
|

Website Aims to Protect Homeowners from Mesothelioma

ByAlex Strauss

Australia’s Cancer Council is trying to educate home renovators about their risk for mesothelioma with a new e-learning course. Australia has one of the highest per capita rates of mesothelioma in the world, largely because of several asbestos mining operations that were once located there. Although asbestos has been banned from building products in Australia since 1989, asbestos-linked diseases like mesothelioma, lung cancer, and asbestosis continue to pose a serious health concern. While mesothelioma has traditionally occurred among people exposed to asbestos on the job, Australia is now bracing for another “wave” of mesothelioma victims among homeowners who encounter asbestos while doing their own renovation projects. Cancer Council Australia has launched “kNOw asbestos in your home” in an effort to…

Radiotherapy for Mesothelioma: Better But Still Limited
| |

Radiotherapy for Mesothelioma: Better But Still Limited

ByAlex Strauss

A form of highly-targeted radiation therapy for mesothelioma is better than it used to be, but is still risky. That is the message of a recent article on intensity-modulated radiation therapy (IMRT) in Seminars in Thoracic and Cardiovascular Surgery. Author Kenneth E. Rosenzweig, MD, a Radiation Oncologist with Mount Sinai Hospital in New York, reviewed recent studies on IMRT and mesothelioma. He concludes that, while the “troubling toxicity” associated with IMRT when it was first introduced has not been entirely eliminated, the fact that clinicians now have more experience with it is making a positive difference for mesothelioma patients. Before targeted therapies like IMRT were available, high-dose radiation was not usually a feasible option for mesothelioma since the irregular shape…

Mesothelioma Nurses Ready for New Cases in Australia
| | |

Mesothelioma Nurses Ready for New Cases in Australia

ByAlex Strauss

Australia is bracing for an expected new wave of mesothelioma cases in the next decade and the Lung Foundation of Australia is taking action now to get ready. The Foundation has paid for ten nurses from around the country to receive specialized training in helping patients and families cope with mesothelioma. The nurses, who have recently completed the training, are now equipped to lead treatment planning for these complex cancer patients and to help other nurses do the same. Pleural mesothelioma is an aggressive cancer that occurs in the lining around the lungs. It is caused by exposure to asbestos dust, a toxin that was once alarmingly prevalent in Australia where it was mined and heavily used in construction. Because…