Combination Therapy Shows Promise for Mesothelioma Treatment

Malignant pleural mesothelioma patients who are treated with photodynamic therapy (or PDT) after undergoing lung-sparing surgery exhibit superior survival rates when compared to patients who undergo traditional extrapleural pneumonectomy (EPP).  EPP is removal of a lung and surrounding tissue for those suffering from non-small cell lung cancer. 

The results are the conclusion of new research recently released from the Raymond and Ruth Perelman School of Medicine at the University of Pennsylvania and published in the June issue of the Annals of Thoracic Surgery.

Photodynamic therapy is a unique type of treatment which uses modulated light waves delivered via catheterization to blast cancerous tissues that have been pre-treated with photosensitizing agents.  The treatment itself has been used for years to treat various types of cancer and has been found to significantly decrease tumor size in a majority of patients. 

This new research compared results from two groups of patients:  Those who underwent lung removal surgery and those who chose lung-sparing surgery.  Both groups were treated with PDT after surgery.  Joseph Friedberg, MD, and co-director of the Penn Mesothelioma and Pleural Program, found that patients who chose lung-sparing therapy fared much better.

"Unlike patients who receive traditional lung sacrificing surgery for mesothelioma,” said Doctor Friedberg, “the patients in our study who underwent lung sparing surgery and photodynamic therapy, a light-based cancer treatment, have experienced unusually long overall survival rates.” 

In fact the survival rate has been extended to remarkable lengths in those patients.  “The median survival for those patients had not been reached at over two years when the results were analyzed. That's unusual in this field, especially when the majority of the patients is older and has advanced cancer."  

While adding two years to a patient’s life span may not sound like much a victory, mesothelioma is an extremely aggressive and deadly form of cancer.  In fact, by the time most patients are diagnosed with the disease, they have less than a year to live, commonly as little as three to nine months. 

Friedberg performed these surgeries himself and his data was cited in the journal article.  He notes the fact that patients are able to keep their lungs intact as being a significant contributing factor to the radical improvement after treatment.  "In addition to the overall survival statistics, the difference between having and not having a lung, both with respect to the risk of surgery and the ability to enjoy a normal life after surgery, is crucial for these patients."

Pleural mesothelioma is the most common form the asbestos related cancer, although tumors can also form in the heart and abdomen as well.   Pleural mesothelioma accounts for roughly 70 percent of mesothelioma cases and is the most aggressive and debilitating form of the disease. 

The most common form of treatment for this type of cancer is surgery to remove tumors combined with chemotherapy and radiation.  These treatments significantly decrease the quality of life many patients enjoy during their final months or years and doctors searching for better alternatives have turned toward lung-sparing surgeries and radical therapies such as PDT. 

Friedberg cites the quality of life factor as the "primary motivation” for his research into PDT. 

The research has spawned excitement and interest in the field and in order to better understand the results further investigations is currently underway at Pennsylvania.