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Systemic Chemotherapy for Mesothelioma

Mesothelioma & Chemotherapy

Researchers are investigating a new way of delivering combination chemotherapy systemically to treat mesothelioma and other types of pleural cancer.  Mesothelioma is a rare cancer caused by exposure to asbestos that develops in the thin membranes that surround various internal cavities of the body.  Malignant pleural mesothelioma is the most common form, with cancer first developing in the pleural or thin membrane surrounding the lung.  Mesothelioma can also occur in the peritoneum (abdomen) and pericardia (heart).

Mesothelioma is often not diagnosed until it has reached advanced stages, when treatment options are more limited.  Chemotherapy is almost always used to treat mesothelioma, usually in combination with other therapeutic interventions.  Even with chemotherapy and other treatments, patients have had low response rates without any significant improvement in overall survival.  Therefore, clinical trials have been investigating more effective ways to intervene medically to get better response rates for pleural malignancies.

Systemic Chemotherapy

One study investigated systemic chemotherapy versus standard.  Systemic chemotherapy delivers anticancer drugs through the blood to cells in the body either intravenously or orally.  A standard chemotherapy drug for mesothelioma is cisplatin and pemetrexed.  Given alone, neither seems to have much effect on pleural cancers.  This clinical study however systemically combined antifolate pemetrexed to cisplatin, and the results showed increased survival time.  The same was true when bevacizumab (an antivascular endothelial growth factor antibody) was combined with carboplatin and paclitaxel (two other standard chemotherapy drugs.)

In addition to showing some increase to survival time, the combination and systemic method increased palliative relief.  Malignant pleural mesothelioma can be quite painful and scary as fluid builds up on the lungs internally, making it difficult to breathe, sleep and eat.  Any treatments that decrease these symptoms, and the pain and anxiety that come with them, is welcomed and needed.

Clinical trials

Clinical Trials will continue exploring using multiple agents for definitive treatments and to increase effectiveness of multimodal strategies for treating mesothelioma.   To find out what current clinical trials are taking place in your area, consult with your oncologist or visit the National Cancer Institute.