| |

Predicting Mesothelioma Treatment Response

ByHolly Zink
Predicting Mesothelioma Treatment Response

Certain types of biomarkers can help doctors predict the best chemotherapy treatment for patients with malignant pleural mesothelioma.

Researchers from Cairo University in Egypt looked at 91 mesothelioma patients. They tested two different chemotherapy drug combinations: pemetrexed plus cisplatin and gemcitabine plus cisplatin.

FDA Approved Treatment Options

Mesothelioma is a rare cancer caused by asbestos and standard therapies are limited. Most mesothelioma patients have chemotherapy as their first-line treatment. If they are healthy enough, they may also have surgery or radiation therapy.

Chemotherapy is a group of toxic drugs that kill cells by damaging their DNA. As of this writing, the only FDA approved chemotherapy for malignant pleural mesothelioma is a combination of pemetrexed and cisplatin.

Gemcitabine is not an FDA-approved treatment for mesothelioma, but researchers have been exploring its use as a second-line treatment.

Biomarkers Predict Individual Patient Response

The goal of this study was to find out if certain biomarkers could predict how a mesothelioma patient might respond to different chemotherapy regimens.

The researchers looked at three biomarkers: thymidylate synthase, ERCC1, and RRM1.

Patients with lower levels thymidylate synthase had better treatment outcomes with pemetrexed-based chemotherapy. On the other hand, Patients with low levels of RRM1 has better overall survival on gemcitabine plus cisplatin chemotherapy.

Patients with low levels of ERCC1 had a better response to both chemotherapy regimens with cisplatin.

The researchers recommend that ERCC1 expression should be tested in patients with malignant pleural mesothelioma before starting chemotherapy with cisplatin. They think that if the levels of ERCC1 are high, the patient might be a better candidate for immunotherapy than chemotherapy.

If a doctor wants to start chemotherapy with pemetrexed, they might want to test levels of thymidylate synthase in the patient. If the levels are high, they might not respond well to this type of treatment.

A test for RRM1 levels in a mesothelioma patient could indicate whether gemcitabine-based chemotherapy will be helpful.

Source:

Wahba NI, Khorsid O, Abo Elkasem F, Bahnassy A, Gaafer R. The Predictive Value of ERCC1, RRM1, and Thymidylate Synthase in Advanced Malignant Pleural Mesothelioma Patients Treated with Platinum-Based Chemotherapy. Asian Pac J Cancer Prev. 2023:24(1);195-205. doi: 10.31557/APJCP.2023.24.1.195. https://pubmed.ncbi.nlm.nih.gov/36708568

 

Similar Posts

  • | |

    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…

  • | |

    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…

  • | |

    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…

  • | |

    A Second-Line Option for Mesothelioma?

    ByAlex Strauss

    Although survival was not significantly extended, the chemotherapy drug vinorelbine might be a treatment option for mesothelioma patients whose cancer has returned after first-line chemotherapy with pemetrexed. A new study on vinorelbine as a second-line treatment finds that the drug is “moderately active” in mesothelioma patients who were initially treated with pemetrexed-based chemotherapy. Pemetrexed (Alimta), along with a platinum-based drug like cisplatin, is the primary first-line drug therapy for mesothelioma. But vinorelbine is gaining attention as a possible option for mesothelioma, in part because it is available in a less expensive generic form. In “Vinorelbine in pemetrexed-pretreated patients with malignant pleural mesothelioma”, the Italian authors detail the results of their study on 59 patients with unresectable pleural mesothelioma.  These patients…

  • |

    Mesothelioma Blood Test May Be Possible

    ByAlex Strauss

    An international team of researchers is studying the proteins found on the surface of cancer cells in an effort to improve mesothelioma diagnosis. The team, made up of scientists from the US, Switzerland, Italy and Chile, has just published their findings on a new kind of test to identify protein-derived mesothelioma biomarkers in blood serum. Mesothelioma is an aggressive cancer of the membranes around organs. Because the most common mesothelioma biomarker, mesothelin, is also overproduced by other kinds of cancer cells, it has only limited diagnostic value. A test to identify a set of proteins produced specifically by mesothelioma cells could greatly improve diagnostic accuracy. Led by Ferdinando Cerciello and Bernd Wollscheid of the Institute of Molecular Systems Biology in…

  • | |

    Repeat HIPEC Improves Mesothelioma Survival

    ByAlex Strauss

    If one cytoreductive surgery and HIPEC procedure for mesothelioma is good, subsequent treatments may be even better. That is the central message of research conducted at the Moffitt Cancer Center in Florida. The study’s aim was to assess overall survival among peritoneal mesothelioma patients who had not just one, but two or more rounds of heated intraperitoneal chemotherapy (HIPEC) after cytoreductive surgery. The cytoreduction/HIPEC approach has become popular for peritoneal mesothelioma, a treatment-resistant cancer of abdominal membranes caused by asbestos. Cytoreductive surgery involves removing as much of the mesothelioma tumor as possible from the abdomen. Because the shape and spreading pattern of mesothelioma tumors make complete cytoreduction difficult, the surgery is often followed by a rinse with a heated solution…