Mesothelioma Patient - Pleural Mesothelioma

Mesothelioma Cancer Article

Mesothelioma Patient Information

Our feature article “Chemotherapy for malignant pleural mesothelioma: past results and recent developments” will give you a better understanding of the treatments available for anyone suffering from Mesothelioma.

Mesothelioma is a rare form of cancer. It affects the linings of the cavities around the lungs, stomach, and heart. It is caused by inhaling asbestos fibers, but the cancer usually does not appear until 10 to 40 years after a person first inhales asbestos.

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Review

Chemotherapy for malignant pleural mesothelioma: past results and recent developments

S Tomek1, S Emri2, K Krejcy3 and C Manegold4

1Department of Medicine I, Clinical Division of Oncology, Vienna, Austria

2Department of Chest Disease, Hacettepe University School of Medicine, Ankara, Turkey

3Eli Lilly Regional Operations GesmbH Area Medical Centre, Vienna, Austria

4Clinical Division of Oncology, Department of Medicine, Thoraxklinik Heidelberg, Germany

Correspondence to: Dr S Tomek, Department of Medicine I, Clinical Division of Oncology, University Hospital Vienna, Waehringer Strasse 18-20, A-1090 Vienna, Austria.

Abstract

This review summarises the results of previously conducted clinical trials, and subsequently presents data arising from all phase II-III studies on chemotherapy of malignant pleural mesothelioma (Malignant Pleural Mesothelioma (MPM)) published since the last relevant overview. While response rates exceeding 30% have barely been achieved with established cytotoxic drugs in Malignant Pleural Mesothelioma (MPM) therapy, novel chemotherapeutic agents and their combinations appear more promising. This applies especially to the antimetabolites, and in particular to pemetrexed that produced response rates of up to 45% in combination with platinum compounds. Raltitrexed combined with oxaliplatin has also been shown to be effective, and gemcitabine-applied as a single agent or in combination with cisplatin-as well as vinorelbine appear to improve the quality of life in patients presenting with Malignant Pleural Mesothelioma (MPM). Data can now be more precisely analysed by increasingly implemented randomised studies, applying a standardised staging system, and distinguishing prognostic groups. While chemotherapy for Malignant Pleural Mesothelioma (MPM) remains a challenging task, important steps have clearly been made in the past years to combat this aggressive disease. The publication of pemetrexed with cisplatin phase III results in a peer-reviewed journal may soon establish a standard of care.

British Journal of Cancer (2003) 88, 167-174. doi:10.1038/sj.bjc.6600673

Keywords: malignant pleural mesothelioma; chemotherapy

Although Malignant Pleural Mesothelioma (MPM) aetiology is well known, therapeutic success with this disease has been unsatisfactory. Standard malignant pleural mesothelioma (Malignant Pleural Mesothelioma (MPM)) therapy is still deficient, and decisions for surgical, radiotherapy or multimodal procedures are made on a case-by-case basis. In the majority of cases, a palliative treatment approach remains the only choice. The possibilities to resect Malignant Pleural Mesothelioma (MPM) curatively are rare and only given in early-stage disease. Yet even at this point, resection is a matter of dispute because of historically high morbidity and mortality rates, relapse tendencies and disappointing long-term survival rates (Rusch and Venkatraman, 1996; Boutin et al, 1998). Irradiation for Malignant Pleural Mesothelioma (MPM) assists in repelling tumour growth and temporarily relieving pain, but not attaining appreciably lengthened overall survival time (Kutcher et al, 1987; Soubra et al, 1990; Bissett et al, 1991). There is also no clear evidence that multimodality protocols involving surgery, radiotherapy and chemotherapy can improve survival (Antman et al, 1980; Hilaris et al, 1984; Linden et al, 1996). Although success in Malignant Pleural Mesothelioma (MPM) chemotherapy has been limited, it now gives rise to promise by the use of an established and standardised staging system, with consideration given to prognostic factors and development of novel cytostatic agents.

Role of Chemotherapy

Chemotherapy for Malignant Pleural Mesothelioma (MPM) continues to be challenging. A multitude of cytotoxic drugs have been tested both as single agents and in combination chemotherapy regimens. The rates of objective tumour regression have only been between 10 and 30% with cytotoxic monotherapy, having no significant impact on median survival. Combination chemotherapy has shown no clear advantage over single-agent therapy (Linden et al, 1996).

Mesothelioma Information

Mesothelioma Cancer is contracted as a direct result of exposure to asbestos. Asbestos is a group of six naturally occurring metamorphic minerals that were commonly used throughout the twentieth century (and today in certain locations around the world) for a variety of industrial purposes.

There are three specific types of mesothelioma asbestos:

Mesothelioma symptoms vary dependent on the type of mesothelioma that one is suffering from; however, the most common presenting symptom is chronic chest pain caused by a buildup of fluid inside the pleural space.

Mesothelioma treatment options include surgery, radiation therapy, chemotherapy (Alimta, Veglin, cisplatin, gemcitabine), photodynamic therapy, immunotherapy and gene therapy; however, none of the mesothelioma treatments have been able to thwart the rare yet deadly cancer type.

If you or a loved one has been diagnosed with malignant mesothelioma, contact an asbestos attorney or mesothelioma attorney to get information about your right to compensation.

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