A recent article in the World Journal of Gastroenterology detailed the progress that has been made – and continues to be made – in the treatment of peritoneal mesothelioma in the last decade. Peritoneal mesothelioma is a type of mesothelioma that occurs on the peritoneum, the lining around the abdominal organs. It accounts for less than a third of mesothelioma cases.
In the new article, surgeons with Virginia Commonwealth University’s School of Medicine and the Massey Cancer Center in Richmond report that the increasing use of cytoreductive surgery combined with a rinse of heated chemotherapy drugs has significantly improved survival rates for peritoneal mesothelioma patients. Whereas early treatment options like debulking surgery, intraperitoneal chemotherapy, and systemic chemotherapy held the median survival of peritoneal mesothelioma at about a year, the newer treatments have more than doubled that.
“The advent of cytoreduction (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) has dramatically improved survival outcomes with wide median survival estimates between 2.5 to 9 years,” writes lead investigator Ali Raza, MD. Dr. Raza points out that the big survival differences between studies are due to differences in study populations, tumor biology and the exact treatment regimens used. The team suggests that more evenly-matched studies are needed to clarify exactly how well the CRS/HIPEC approach is working.
But CRS/HIPEC is not the only promising treatment approach for peritoneal mesothelioma. Scientists are also working to identify molecular targets that will allow them to treat peritoneal mesothelioma from the inside out. One of the newest targets is sphingosine kinase 1 (SphK1) which regulates the production of a lipid that has been linked to mesothelioma. “The known action of specific SphK inhibitors may warrant further exploration in peritoneal disease,” writes Dr. Raza.
Raza, A et al, “Advanced in the management of peritoneal mesothelioma”, September 7, 2014, World Journal of Gastroenterology, pp. 11700-11712