Clapper, Patti, Schweizer and Mason

Mesothelioma is an aggressive form of cancer that affects the mesothelium, or protective sac that lines the pleura (lungs), peritoneum (abdomen), or pericardia (heart). Exposure to asbestos is the primary cause of mesothelioma. So far, there are no known cures and standard treatments have not been very effective at extending survival times, although much research continues in this area.

 

Standard treatments for mesothelioma include surgery, chemotherapy and radiation therapy. The two most common drugs used in chemotherapy are cisplatin and pemetrexed. With some, this form of treatment not only has palliative effects but also does extend survival times to a limited extent. With many, frontline treatments have short lived effects and the symptoms of mesothelioma return and progress very quickly, known as recurrent mesothelioma.

 

No standard treatment approaches have been proven to improve survival or control symptoms for a prolonged period of time. Therefore, research has begun into the treatment of recurrent mesothelioma. 

Therapies for recurrent mesothelioma usually utilize procedures and/or agents not previously employed in the initial treatment attempt. Patients who have undergone frontline treatment should consider being candidates for phase I and II clinical trials evaluating new biologicals, chemotherapeutic agents, or alternative physical approaches.

 

Clinical trials are now being conducted where patients with recurrent epitheliod malignant mesothelioma are being re-treated with combinations of cisplatin and pemetrexed. Initial results published in the International Journal of Clinical Oncology in April show that this strategy can lead to tumor regression of six months or more. Researchers suggest that further studies be conducted to better identify how effective re-treatment is and which patients are best suited for it.

 

For a current list of active clinical trials treating recurrent mesothelioma and for protocols around second line therapies, visit the National Cancer Institute website.