Second-Line Mesothelioma Treatment

Unfortunately, due to the severity and long latency period of the disease, mesothelioma is not often detected in its victims until the advanced stage. Like other cancers, successful treatment of advanced mesothelioma is rare, and the median survival rate is less than one year. First-line therapy for advanced mesothelioma patients is well established, and often includes treatment based on pemetrexed and platin. A recent study by BioMed Central retrospectively collected data of patients treated with this kind of therapy, and followed progression and overall survival after second-line therapy. Mesothelioma attorneys closely follow studies released on the rare and fatal cancer.

New research emerges often because of the high fatality rate and insidious nature of the disease. Mesothelioma is one of the numerous illnesses directly linked to asbestos exposure. Asbestos is an organic mineral used in large amounts throughout the twentieth century, particularly in the automotive, construction, shipbuilding, and textile industries. A large majority of asbestos-related deaths are due to occupational exposure, though diseases may develop through environmental exposure (large organic asbestos deposits are prevalent throughout the United States), the use of asbestos-containing products, such as vermiculite gardening products, or living in close vicinity to former asbestos-manufacturing plants.

The current standard of care in the management of advanced malignant pleural mesothelioma is a platinum-based chemotherapy. A landmark study by Vogelzang and Colleagues compared cisplatin plus pemetrexed to cisplatin treatment alone, demonstrating a survival benefit for the combination of 2.8 months versus cisplatin alone.

In absence of a standard second-line treatment for malignant mesothelioma, BioMed hypothesized efficacy from re-treatment with pemetrexed alone or in combination with platin. They analyzed characteristics and outcome only of those patients treated again with a pemetrexed-based therapy after progression. They collected 30 patients, sixteen of whom had a history of exposure to asbestos, while it was unknown or unclear for all the others.

Response rate after re-treatment was as follows: 10 patients showed progression of disease (33%), most of patients had stability of disease, 15 out of 30 patients (50%), while 5 patients showed a partial response (17%); median duration of stable disease in patients being retreated was 4.7 months.

They also collected information during re-treatment about symptom control. Pain decreased in 13 out of 30 patients (43%), 7 patients (23%) had no pain at all, while 10 patients (33%) reported a worsening of their pain.

Overall, time to progression and survival were promising for a second-line setting of patients with advanced mesothelioma, at 5.1 and 13.6 months, respectively. Interestingly there are two papers, this one and one by French researchers Ceresoli and Colleagues, with similar results. The BioMed patients consistently support the data from Ceresoli and Colleagues and strengthen the results for the use of pemetrexed-based re-treatment as second-line. When patients had a benefit from a platin-pemetrexed combination, in the absence of other effective strategies, BioMed strongly suggests a re-treatment with the same drugs, because an improvement of the symptoms and a consistent gain in time to progression can be still obtained.

Malignant mesothelioma is a very aggressive disease with poor outcome even when radical surgery is possible. When curative surgery is not available, patients are offered palliative chemotherapy, though in randomized clinical trials a platin-combination with pemetrexed or raltitrexed have given better results. Out of those combinations, there are no recommended salvage therapies when patients experience a progression. When progression occurs at least 6 months after the end of previous treatment, a re-challenge with the same drugs is offered because antagonistic to growth activity is considered still possible. Based on the lack of alternatives and in analogy with other malignancies, BioMed proposes a re-treatment with the same therapy used as first-line for patients affected by advanced mesothelioma.

Mesothelioma lawyers at Pintas & Mullins Law Firm are committed to the advancement of cancer treatment and care. If you were exposed to asbestos in any form or environment and developed a related disease, you may be entitled to compensation. Contact one of our asbestos exposure attorneys immediately for a free legal consultation.

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