Mesothelioma Information - Asbestos Lung Cancer
Topoisomerase interactive agents
Camptothecin analogues
Irinotecan: The activity of single-agent irinotecan (125 mg m-2 given weekly for 4 weeks, every 6 weeks) in malignant mesothelioma was investigated by the CALGB (Kindler et al, 2000). In 28 patients evaluable for analysis, no complete or partial responses were observed and the median overall survival was 7.9 months, indicating that irinotecan, at least in this dose and schedule, had no antitumor activity and considerable toxicity (leucopenia, neutropenia, diarrhoea).
Furthermore, the combination of irinotecan and cisplatin was evaluated by a Japanese group (Nakano et al, 1999). A total of 15 chemonaive Malignant Pleural Mesothelioma (MPM) patients were treated with irinotecan at 60 mgmg-2 on days 1, 8 and 15 and cisplatin at 60 mg m-2 on day 1, repeated every 28 days. A response rate of 26.7% (four partial responses) was observed and the median survival after chemotherapy was 28.3 weeks. In contrast to the trial conducted by the CALGB, Nakano et al,reported definite activity with only mild toxicity of this combination regimen and concluded that it warrants further clinical evaluation.
Recently, Verschraegen et al, (2001) published retrospective data of the same combination in 10 patients with peritoneal mesothelioma. Six courses of irinotecan 50 mg m-2 (day 1, 8 and 15) and cisplatin 50 mg m-2 (day 1) were administered every 4 weeks, either intraperitoneally or intravenously, and were well tolerated. The authors reported that 70% of the patients improved on treatment. Owing to the observed clinical benefit, a phase II trial is currently planned.
Topotecan. In order to evaluate the efficacy and toxicity of the camptothecin analogue topotecan in the treatment of Malignant Pleural Mesothelioma (MPM), the North Central Cancer Treatment Group treated 22 Malignant Pleural Mesothelioma (MPM) patients with topotecan 1.5 mg m-2 daily for 5 days at 3-week intervals. 18 patients (86%) experienced grade 3 or 4 neutropenia. There were no objective responses seen and the median survival for all patients was 230 days (Maksymiuk et al, 1998).
Mesothelioma Information
Mesothelioma Cancer is a rare disease that affects the mesothelial tissue lining the three largest body cavities: the lung cavity (pleura), the abdominal cavity (peritoneum) and the heart sac (pericardium).
The most common type of mesothelioma is malignant pleural mesothelioma. Pleural mesothelioma is often confused with asbestos lung cancer because of the close proximity of the two. Asbestos lung cancer affects the parenchymal tissue of the lung, while pleural mesothelioma affects the tissue lining of the lung cavity.
Causes of mesothelioma have been limited to asbestos exposure. Asbestos was commonly used for a variety of industrial purposes. Asbestos fibers are carcinogenic and when inhaled, can lead to a number of asbestos-related diseases.
Mesothelioma treatment options include surgery, chemotherapy, radiation therapy, photodynamic therapy, immunotherapy and gene therapy; however, no mesothelioma treatment has thus far been able to eradicate the deadly cancer type.