Treating Relapses in Malignant Pleural Mesothelioma

Mesothelioma is progressive, fatal form of cancer that is primarily linked with exposure to asbestos.  To date, mesothelioma has proven to be very treatment resistant with increasing frequency throughout the world.  Prognosis is usually poor and the majority of patients live less than a year from time of diagnosis.  Even when initial therapeutic interventions show some results, tumors often recur and secondary treatments for mesothelioma are needed.

In the interest of finding the optimal management technique, researchers from London recently conducted a study to investigate the efficacy and safety of weekly vinorelbine treatments for patients with recurrent mesothelioma who had previously received chemotherapy.    All the patients in the study had been diagnosed with only malignant pleural mesothelioma, almost all were male, and the median age was 59 years.  No deaths occurred as a result of treatments and the vinorelbine appeared to be well tolerated.

Vinorelbine is a semi-synthetic vincal alkaloid with antitumor activity and is usually administered intravenously.  This chemotherapy drug has been used in clinical trials in front-line settings, either alone or as part of two and three part regimens, and is currently being researched as a viable option for recurrent mesothelioma.  

To date, there is no established optimal treatment for second-line therapy for patients with relapsed malignant pleural mesothelioma.  This study reports that weekly treatments with vinorelbine on patients who are diagnosed with pleural mesothelioma and have previously undergone chemotherapy can have some symptomatic benefit as well as extend survival times to a limited extent. 

As there is no known cure for mesothelioma, any treatments that could improve the quality of life for patients are needed.  Given there were no toxicity concerns with this current study, further clinical trials using Vinorelbine are recommended as a first line regimen as well as for patients who relapse.