German doctors say a combination of extended PD surgery and HITHOC has produced some ‘remarkable’ results for patients with pleural mesothelioma.
Extended PD (pleurectomy with decortication) is a lung-sparing surgical procedure for people with cancer on the pleural membrane around the lungs. HITHOC is a method for infusing the area with heated chemotherapy drugs without sending those drugs through the whole body.
Together, extended PD surgery and HITHOC produced median progression-free survival of more than a year and a half for mesothelioma patients in a new German study.
Their experience is the focus of a new article in the journal Respiration.
Removing and Killing Cancer Cells: The One-Two Punch
Malignant pleural mesothelioma is a rare cancer that starts on the lining around the lungs called the pleural membrane. As cancer grows on this membrane, it becomes less pliable. Over time, it gets harder for the lungs to expand and patients become short of breath.
There is no cure for mesothelioma and the prognosis is usually not good. But cancer researchers around the world are working hard to find a way to combat this aggressive malignancy.
PD surgery and HITHOC are like a one-two punch to pleural mesothelioma. During extended PD, doctors remove the diseased pleura. They also remove all or part of the diaphragm and many other tissues in the chest that could harbor new mesothelioma tumors.
The goal of HITHOC is to kill any mesothelioma cells left behind after surgery. Destroying these residual cells prevents them from seeding new mesothelioma tumors.
The Power of PD Surgery and HITHOC
The new German study of extended PD surgery and HITHOC spanned four years and included 76 patients with pleural cancers. Sixty-one of the patients had pleural mesothelioma. The rest had another kind of cancer than had spread to the pleural membrane.
Just over 23 percent of patients had some kind of complication after PD surgery and HITHOC. But no patients died within 30 days. A small percentage (1.3%) died within 90 days.
The median progression free survival with mesothelioma was 18.4 months. Progression free survival is the time after treatment that patients live with the disease without it getting worse. This is significant since mesothelioma is usually fatal within a year of diagnosis.
Lead author Laura Klotz concludes, “Combining EPD with HITOC [HITHOC] can be performed in patients with either pleural mesothelioma or pleural metastases resulting in low perioperative morbidity and mortality as well as remarkable local tumor control.”
Other promising new treatments on the horizon for pleural mesothelioma include a new immunotherapy drug combination and an electrical device called Optune Lua.
Klotz, L, et al, “Cytoreductive Thoracic Surgery Combined with Hyperthermic Chemoperfusion for Pleural Malignancies: A Single-Center Experience”, August 12, 2021, Respiration, https://www.karger.com/Article/Abstract/517334