New evidence suggests that supplementing standard mesothelioma chemotherapy with Avastin (bevacizumab) may lead to less pain. It may also reduce the risk of another mesothelioma complication called peripheral neuropathy.
That word comes from a newly-published study involving several French hospitals. The study is a follow-up to the French-led MAPS study from 2016.
The MAPS study showed that performing mesothelioma chemotherapy with Avastin – in addition to the standard chemotherapy drugs – improved mesothelioma survival by 23 percent.
Now it looks like the three-drug combination can also help mesothelioma patients live longer with fewer side effects.
Mesothelioma Complications and Side Effects
Avastin is a VEGF inhibitor. It works by preventing the formation of blood vessels that feed a growing tumor. The primary goal of the MAPS trial was to assess the survival impact of mesothelioma chemotherapy with Avastin. The second goal was to see how it affected quality of life.
Four hundred and forty-eight patients with advanced pleural mesothelioma enrolled in the MAPS study. The study ran from 2008 to 2014. Some of the patients had chemotherapy with Avastin while others had chemotherapy without it.
Ninety-four percent of the patients filled out a questionnaire about their quality of life as it relates to their health.
The questionnaire included general questions about life with cancer. It also had more specific questions related to lung cancer. Patients filled it out at the beginning of their mesothelioma treatment and again every nine weeks until their cancer progressed.
Life is Better After Mesothelioma Chemotherapy with Avastin
Pleural mesothelioma and treatment can trigger some uncomfortable symptoms. It is common for patients to have chest pain caused by the growing tumor or fluid collection around the lungs.
Peripheral neuropathy can also be a problem. This is a set of symptoms caused by damage to the nerves that control the arms and legs. Some chemotherapy drugs can cause peripheral neuropathy in mesothelioma patients.
But researchers found that the Avastin group lived longer without either of these problems. Many of the patients who had mesothelioma chemotherapy with Avastin were not bothered by peripheral neuropathy for a year or more. Patients who had no Avastin started having problems related to peripheral neuropathy at a median of 7.59 months.
The Avastin group also had less pain than the no-Avastin group. There was no negative impact on quality-of-life from mesothelioma chemotherapy with Avastin.
Since the MAPS study, chemotherapy with Avastin, Alimta (pemetrexed), and cisplatin has been the standard of care in France.
The US National Comprehensive Cancer Network guidelines have also included this combination as an option for first-line mesothelioma treatment since 2016.
Eberst, G, et al, “Health-related Quality of Life Impact from Adding Bevacizumab to Cisplatin-Pemetrexed in Malignant Pleural Mesothelioma in the MAPS IFCT-GFPC-0701 Phase III Trial”, June 7, 2019, Clinical Cancer Research, Epub ahead of print, http://clincancerres.aacrjournals.org/content/early/2019/06/07/1078-0432.CCR-18-2860