The Society of Interventional Radiology reported this week that a new treatment for stage 3 and 4 mesothelioma might enhance the quality of life for patients with few treatment choices, according to a new clinical study. (Sciencedaily.com)

The research shows that transarterial chemoperfusion treatment for pleural mesothelioma has few side effects and shows promise for extending lives of cancer patients who have few treatment options left.

Aggressive Mesothelioma Can Be Treated With New Chemotherapy Option

Pleural mesothelioma is a terrible cancer of the membranes around the lungs that is extremely challenging to treat, according to Bela Kis, MD, Ph.D., the principal investigator on the study, and an interventional radiologist at the Moffitt Cancer Center in Tampa. (Cancer.gov)

Kis noted the usual survival rate for patients in stage 3 and stage 4 of pleural mesothelioma is only 12 months after diagnosis. But this new mesothelioma treatment may give patients months longer to be with their family and friends.

Twenty-seven pleural mesothelioma patients were enrolled in a Phase 2 clinical trial and had chemoperfusion treatment. All patients had gotten chemotherapy before, and many of them had tried several types of cancer drugs. Four of the enrolled patients had radiation, and three had pleurectomy surgery. All of the patients experienced disease progression before they were enrolled in the clinical trial.

What Is Traansarterial Chemoperfusion?

Transarterial chemoperfusion provides a high concentration of drugs to cancerous tissue in the lung lining to enhance treatment with fewer side effects. Unlike other chemotherapy that is provided intravenously and goes through the whole body, radiologists inject a third of the chemotherapy combination (cisplatin, methotrexate, and gemcitabine) into the arterial mammary artery that provides blood to the pleura.

The other ⅔ of the drugs are placed into the descending aorta, which gets to the intercostal vessels that also feed the pleura. The special chemotherapy treatment can be done on an outpatient basis and lasts about an hour, with a one-hour recovery.

Novel Chemotherapy Treatment Shows Impressive Disease Control Rate

Results of the clinical study a 70.3% disease control rate. The median overall survival rate is 8.5 months from the beginning of the novel treatment. The new chemotherapy treatment seems to be well-tolerated by most cancer patients, with only a 1.4% major complication rate. Most reported side effects were minor and included chest pain and mild nausea.

Kis noted the researchers were ‘pleasantly surprised’ to find the new treatment does not have the same side effects of traditional chemotherapy. To see such promising results with few side effects means the new drug regimen can make a positive impact on the quality of life for many mesothelioma patients.

At this time, aggressive surgery is the only effective treatment for most pleural mesothelioma patients, but it is only effective if the disease is diagnosed in stages 1 or 2. Only 10-20% of patients can tolerate surgery and many have serious complications.

Study researchers want to expand their study to other US cancer centers with bigger pleural mesothelioma populations because the cancer is so rare. They also want to increase flexibility in the study to allow for boosting the dosage and altering the combination of the drugs for some patients to see if these approaches could enhance outcomes.

Clinical Study Eligibility Criteria

This clinical study is open to men and women who are 18 or older with the following inclusion criteria:

• Must have malignant pleural mesothelioma confirmed histologically or cytologically.
• Cancer must be unresectable or the patient has declined the surgery.
• Must not have responded well to first-line chemotherapy, or the patient declines first-line chemotherapy.
• Must have mesothelioma that is measurable by CT or MRI. Radiographic tumor assessment must be done four weeks before the initial treatment.

Phase 2 studies take about two years to complete, and they usually have 30-120 patients. But researchers may assign patients various doses of the treatment, which is known as a randomized Phase 2 trial.