| | | |

Second Line Mesothelioma Treatment Shot Down in New Study

ByAlex Strauss
second line mesothelioma treatment

Italian researchers say there is good news and bad news about a proposed second line mesothelioma treatment. 

The good news is that the treatment did not cause major side effects in the patients who tried it. The bad news is that it also did not help them live any longer. 

The treatment is a mixture of gemcitabine and imatinib. Animal studies suggested that the combination might improve mesothelioma survival. 

The newly-published study shows the second line mesothelioma treatment did help control the disease in most patients. But the 23 patients who tried it only lived for a median of 5.7 months. That was not enough for doctors to recommend the combination.

Mesothelioma Chemotherapy and Survival

The most common first line treatment for mesothelioma is chemotherapy. Most patients have a combination of Alimta (pemetrexed) and cisplatin. 

Unfortunately, this ‘gold standard’ mesothelioma therapy is only moderately effective. For most patients, their tumors start growing back within a few months. Previous studies suggest standard chemotherapy extends mesothelioma survival by about four months. 

Doctors have tested a number of different second line mesothelioma treatments. One of the most recent studies focused on a drug called lurbinectedin. Lurbinectedin impacts cancer cells at the DNA level. But the 2019 Swiss study found it barely met the progression-free survival goal of three months. 

Some other tested second line treatments include:

  • Additional rounds of pemetrexed
  • Taxane and gemcitabine
  • Docetaxel
  • Avelumab
  • Tremelimumab

None of the drugs tested have improved mesothelioma survival by more than eight months. 

Gemcitabine Combo as a Second Line Mesothelioma Treatment

The latest search for a second line mesothelioma treatment focuses on gemcitabine again, but in combination with a different drug. Imatinib mesylate sells under the brand name Gleevec. It is a protein tyrosine kinase inhibitor usually used for certain kinds of leukemia. 

Italian doctors gave the combination to patients who already had at least one cycle of standard chemotherapy. Their tumors also had to shower elevated levels of the protein PDGFR-β and/or cKIT. 

Patients received gemcitabine on days 3 and 10 and took oral imatinib daily for two different five-day stretches. The goal for this second line mesothelioma treatment was for at least three quarters of the patients to live for three months without their cancer coming back.  

Twenty-three patients received the treatment combo. In four of them, their mesothelioma tumors actually shrank a little. Eleven others had stable disease. But only 39 percent of patients met the three-month progression-free survival goal. 

“The combination of IM and GEM is well tolerated in platinum-pemetrexed-pretreated MPM patients…but it does not show a significant progression free survival benefit,” concludes study author Paolo Andrea Zucali. 

The fact that this second-line therapy did not extend survival for these patients does not mean that no second mesothelioma treatment can help. If you have been through mesothelioma chemotherapy and your cancer has come back, discuss possible second line options with your doctor. In some cases, they may be available through a clinical trial.

Source:

Zucali, PA, et al, “A phase II study of the combination of gemcitabine and imatinib mesylate in pemetrexed-pretreated patients with malignant pleural mesothelioma”, February 12, 2020, Lung Cancer, Epub ahead of print, https://www.lungcancerjournal.info/article/S0169-5002(20)30301-9/fulltext

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…

  • |

    Mesothelioma Still Rising Despite Ban in Ireland

    ByAlex Strauss

    A study in Ireland confirms that it can take many years for a ban on asbestos to have a measurable impact on a country’s rates of malignant mesothelioma. Mesothelioma is the most serious of a list of diseases – including lung cancer, pleural plaques, asbestosis, and others – linked with exposure to asbestos dust. Affecting the linings around the lungs and other organs, mesothelioma is often resistant to most cancer treatments and may be fatal within a year of diagnosis. According to the International Ban Asbestos Secretariat, Ireland is one of 55 countries that have enacted some type of asbestos ban. However, although Ireland banned asbestos in 2000, a new study published in Cancer Epidemiology shows that incidence of the…

  • | |

    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…

  • |

    Website Aims to Protect Homeowners from Mesothelioma

    ByAlex Strauss

    Australia’s Cancer Council is trying to educate home renovators about their risk for mesothelioma with a new e-learning course. Australia has one of the highest per capita rates of mesothelioma in the world, largely because of several asbestos mining operations that were once located there. Although asbestos has been banned from building products in Australia since 1989, asbestos-linked diseases like mesothelioma, lung cancer, and asbestosis continue to pose a serious health concern. While mesothelioma has traditionally occurred among people exposed to asbestos on the job, Australia is now bracing for another “wave” of mesothelioma victims among homeowners who encounter asbestos while doing their own renovation projects. Cancer Council Australia has launched “kNOw asbestos in your home” in an effort to…

  • | |

    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…

  • | | |

    Mesothelioma Nurses Ready for New Cases in Australia

    ByAlex Strauss

    Australia is bracing for an expected new wave of mesothelioma cases in the next decade and the Lung Foundation of Australia is taking action now to get ready. The Foundation has paid for ten nurses from around the country to receive specialized training in helping patients and families cope with mesothelioma. The nurses, who have recently completed the training, are now equipped to lead treatment planning for these complex cancer patients and to help other nurses do the same. Pleural mesothelioma is an aggressive cancer that occurs in the lining around the lungs. It is caused by exposure to asbestos dust, a toxin that was once alarmingly prevalent in Australia where it was mined and heavily used in construction. Because…