All About Mesothelioma

New research from Europe suggests that a drug known as gemcitabine, given along with one that is now commonly used for mesothelioma, might someday serve as another weapon in doctors’ arsenals against the cancer.

Gemcitabine (marketed as Gemzar) is a chemotherapy drug currently in use to treat lung, breast, pancreatic and ovarian cancers. In the recent, Phase II study—designed to test whether the drug is effective and to measure side effects and other risks—investigators in Slovenia gave patients with malignant pleural mesothelioma a prolonged, low-dose infusion of gemcitabine in combination with cisplatin (marketed as Platinol).

The researchers decided to test this course of therapy against malignant pleural mesothelioma—a cancer in a layer of specialized cells, called mesothelial cells, that line the chest and are adjacent to the lungs—after noting that the treatment appeared to be effective in advanced cases of the most common type of lung cancer, non–small-cell lung cancer.

Patients in the mesothelioma study were eligible if they had not previously received any chemotherapy, and other than the mesothelioma, were in fair to good health with normal liver and kidney function. The treatment entailed six three-week cycles of therapy. For the first four cycles, patients received six-hour infusions of gemcitabine on the first and eighth days, plus cisplatin on the second day; the last two cycles included the gemcitabine but not the cisplatin. A total of 78 patients—58 men and 20 women, ages 33 to 82 years old—participated. More than 70 percent of the patients had mesothelioma tumors of the most common subtype, known as epitheloid, a categorization based on certain characteristics of the cancer cells.

Four of the patients, or 5 percent, showed a complete response—meaning their cancer was undetectable—after the therapy. Thirty-five had a partial response—meaning the size of their tumors was reduced substantially. Another 35 patients had tumors that either responded minimally or remained stable, while only four patients experienced tumor progression during the treatment.

Sixty-seven percent of the mesothelioma patients survived one year after therapy; almost 33 percent survived two years, and about 20 percent survived three years. Patients who had epitheloid tumors were more likely to survive longer without their tumor progressing, and to survive longer overall, compared with patients who had other tumor subtypes.

Most of the patients experienced an improvement in mesothelioma symptoms, and a quality of life that either remained the same or improved, the researchers reported. Notable side effects included neutropenia (a shortage in a type of white blood cells, which can impair the immune system), anemia (a shortage of red blood cells, which can cause fatigue) and hair loss, as well as thrombocytosis (an excess of blood platelets, which cause clotting). Because the therapy appeared to slow down the mesothelioma’s progress and didn’t prove to be too toxic, the scientists advised that this mesothelioma treatment approach warranted further research.

View the original article here