Chemotherapy, Immunotherapy, Radiation & Surgery – University of Pisa
Multimodality therapy has long been used to treat mesothelioma and other cancers. The concept is that there may be synergies between various treatments. Even if there are not synergies, there may be an additive effect. Obviously, whatever treatment works can be useful so combining useful treatments seems like a common sense approach.
In this clinical trial that was started in 1999, 49 patients with pleural mesothelioma were enrolled in this study. The study used a variety of treatments including: immunotherapy (interleukin 2), surgery (pleurectomy/decortication), antineoplastic antibiotics (epidoxorubicin, radiotherapy, and chemotherapy (cisplatin and gemcitabine).
After approximately 59 months, 13 patients were still alive and the median survival was 26 months . Typically, multimodality treatments as intensive as this often have very severe side effects. However, in this clinical trial the researchers did not report any deaths immediately after the surgery.
Today, many of the treatments used in this multimodality approach are still being used especially the surgery pleurectomy/decortication.
Patients: This phase II study involved 49 patients with stage II-III malignant pleural mesothelioma. There were 41 men and 8 women, with a median age of 61 years (ranging from 41-77).
Treatment: These patients received a surgery (thoractomy or pleurectomy/decortication), the chemotherapy drugs epidoxorubicin, cisplatin, and gemcitabine, the immunotherapy interleukin-2, and radiation.
Toxicity: During the chemotherapy treatment, toxicities included neutropenic fever, alopecia, nausea/vomiting, usuall mild or moderate. Radiation-related toxicity was actinic pneumonia, which was recorded in 38 patients. The IL-2 therapy was associated with mild fever and eosinophilia.
Results: The overall median survival was 26 months. The median survival for patients with stage II disease was 31 months, and for those with stage III disease it was 21 months.
Correspondence: Dr. Marco Lucchi
See all conventional treatment results for mesothelioma.