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Overall Survival “Significantly Higher” After Second-Line Chemotherapy

919316_chemo drugResearchers in a country especially prone to mesothelioma say second-line chemotherapy with a drug called gemcitabine can significantly improve survival.

Turkey is home to several cities with some of the highest rates of mesothelioma in the world. It is also the site of aggressive mesothelioma research. Doctors in the Department of Medical Oncology at Acibadem Kayseri Hospital in Kayseri, Turkey, have just released their findings on second-line treatment with gemcitabine (Gemzar) and the results contain some encouraging news for patients struggling with malignant pleural mesothelioma.

A total of 73 mesothelioma patients from four different Turkish institutions were evaluated based on whether or not they had second-line chemotherapy with gemcitabine, an antimetabolite that prevents cancer cells from making new DNA and RNA. All of the mesothelioma patients in the study had first-line chemotherapy with a pemetrexed-based regimen, the most popular treatment for mesothelioma.

On average, the patients who received second-line chemotherapy with gemcitabine survived for a median of two months longer than those who received no second-line chemotherapy. In addition, when the researchers looked at the rates of survival among the two groups at 6, 12, 18, 24, and 36 months, there were significantly more patients in the gemcitabine group alive at 36 months than there were in the first-line chemotherapy-only group.

For patients who had pemetrexed-based chemotherapy followed by gemcitabine-based treatment, the median overall survival was 20.8 months from diagnosis. In contrast, patients who only had first-line chemotherapy followed by palliative care to manage their symptoms had an overall survival of just one year and one month from diagnosis.

“According to our results, we may consider gemcitabine-based regimens as a second-line chemotherapy after treatment with pemetrexed plus platinum in patients with malignant pleural mesothelioma,” concludes lead researcher Hasan Mutlu, a medical oncologist with Acibadem Kayseri Hospital.

The high rates of mesothelioma in certain Turkish cities are blamed on high levels of erionite, a mineral similar to asbestos, in the soil. Rocks containing erionite have traditionally been used to build homes and public buildings in these cities. Elsewhere in the world, most cases of mesothelioma are due to occupational or environmental asbestos exposure.


Mutlu, H et al, “Second-line gemcitabine-based chemotherapy regimens improve overall 3-year survival rate in patients with malignant pleural mesothelioma: a multicenter retrospective study”, August 3, 201, Medical Oncology, Epub ahead of print.

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