Clapper, Patti, Schweizer and Mason

Combination Drug Treatments for Malignant Pleural Mesothelioma 

Malignant pleural mesothelioma is an aggressive cancer that continues to be a challenge for health care providers and scientists who are in the field of asbestos related diseases. A multidisciplinary approach is required in the diagnosis and treatment of mesothelioma.   A pleural biopsy, preferably a thorascoscopy, and an immunohistochemistry is often used to diagnose mesothelioma. Immunohistochemical staining is a method used to detect the presence of specific proteins in cells or tissues and localize antigens. Calretinin, podoplanin, WT1 and cytokeratin 5/6 have been identified as positive markers for mesothelioma. 

Carboplatin & Pemetrexed Have Less Side Effects for Mesothelioma Patients

Standard treatment for mesothelioma after diagnosis are chemotherapy, surgery, and radiotherapy. The preferred first line of treatment of mesothelioma has been chemotherapy with cisplatin plus pemetrexed. While this combination can improve overall survival rates, accompanying toxicity has drawbacks. Other drugs, such as the combination of cisplatin and gemcitabine, have also shown some promise and are being researched in clinical trials. Substitution of cisplatin with carboplatin has been one attempt to decrease common side-effects. 

Carboplatin, a platinum analog that is better tolerated and easier to administer, has been one such drug under investigation. Current trials using pemetrexed and carboplatin show the combination is synergistic, well tolerated, and increases overall survival. These results are similar to those achieved with the standard treatment of pemetrexed and cisplatin, however with fewer side effects of nausea, vomiting, and fatigue. Although further research is needed, different drug combinations show promise of being viable alternative options in the treatment of malignant pleural mesothelioma. 

Encouraging results have been reported using multidisciplinary teams and multimodality approaches. Combined regimens in chemotherapy have shown significant advantages in terms of survival, time to progression, and response rate. Although research has produced small steps forward, improved therapeutic strategies are still needed and are being explored. 

Disclaimer:  Information shared here are in efforts to aid those diagnosed with mesothelioma with current information and resources. Information shared is intended to supplement the care provided by your health care team. Always seek the advice of your doctor and medical expert prior to starting any new treatment or with questions regarding your medical condition. Call your healthcare provider immediately if you think you have a medical emergency and to explore treatment options that are best suited to your particular condition.