Oncologists report that a second treatment course may be a good option for some mesothelioma patients. Almost all mesothelioma patients experience progression after the first treatment. Recommendations for a second treatment are still unclear. There is very limited information available on second and repeat treatments.
Pemetrexed combined with platinum-based chemotherapy is a standard first treatment for mesothelioma. A report in BMC Cancer says that a repeat treatment may be good for eligible patients.
In this study, patients who received a second treatment of chemotherapy survived longer.
Understanding Second Treatments or Retreatments
Malignant pleural mesothelioma is a rare, aggressive cancer linked to asbestos exposure. There have been several recent treatment advances. But the mesothelioma prognosis is still poor with an average survival of one year. Only 10% of patients survive longer than five years.
The standard treatment approach for malignant pleural mesothelioma is surgery and chemotherapy. Unfortunately, most patients are not eligible for surgery. Palliative chemotherapy is often the only possible strategy.
Pemetrexed combined with platinum-based chemotherapy is the standard first treatment option. A clinical trial has also shown the benefit of the addition of bevacizumab.
Despite progress, almost all mesothelioma patients experience cancer progression after the first treatment. There is limited information on the second and later treatments available for patients.
Evaluating Later Treatment Options
Patients who have a good response rate from the first treatment are often offered more. This study evaluated second and repeat treatments with pemetrexed-based chemotherapy.
The research team analyzed 57 patients from two Polish oncological hospitals. These patients were all treated for advanced mesothelioma between 2013 and 2019. Patients were an average of 64 years old.
In the first treatment, 55 patients received pemetrexed-based chemotherapy. Twelve patients received a second treatment. Seven of these received pemetrexed-based chemotherapy.
Patients with a repeat treatment of pemetrexed-based chemotherapy survived 4.5 months longer.
Malignant mesothelioma patients who have a good response from the first treatment and survive longer than 6 months should be offered a repeat treatment.
The option of retreatment could be a good option when no other treatments are available. These results support other studies in this area.
Retreatment with the same chemotherapy type may be a good option. Especially if the first treatment was a pemetrexed/platinum combination. And particularly whenever no alternative therapy is available.
Ziółkowska, Barbara, Bożena Cybulska-Stopa, Dimitrios Papantoniou, and Rafał Suwiński. “Systemic treatment in patients with malignant pleural mesothelioma–real life experience.” BMC cancer 22, no. 1 (2022): 1-8. https://link.springer.com/article/10.1186/s12885-022-09490-8