Mesothelioma Cancer - Pemetrexed, Gemcitabine
Another phase I pemetrexed study demonstrated clinical activity in combination with carboplatin. A total of 27 patients were treated with various dose levels of pemetrexed and carboplatin on day 1 of a 21-day schedule (Hughes et al, 2002). In 25 evaluable patients, eight (32%) achieved a partial remmission and 14 experienced stable disease at various dose levels. Furthermore, a symptomatic improvement was documented in 19 cases.
A two-stage phase II trial has just been completed by Scagliotti and collaborators, investigating single-agent pemetrexed in the treatment of Malignant Pleural Mesothelioma (MPM). A total of 62 patients were given pemetrexed at 500 mg m-2 on day 1, every 3 weeks. Scagliotti et al, (2001) reported a response rate of 14.5% and a median survival of 10.7 months.
Furthermore, a randomised phase III trial comparing pemetrexed plus best supportive care vs best supportive care alone in previously treated patients with Malignant Pleural Mesothelioma (MPM) is currently ongoing.
Nucleoside Analogues
Gemcitabine. The activity of single-agent gemcitabine at 1250 mg m-2 on days 1, 8 and 15 on a 28-day schedule was evaluated by the EORTC-Lung Cancer Group in 27 chemotherapy-naive subjects with Malignant Pleural Mesothelioma (MPM) (van Meerbeeck et al, 1999). Two partial responses were achieved for an overall response rate of 7%. An additional 56% experienced disease stabilisation and overall median survival was 8 months.
The CALGB administered high-dose gemcitabine at 1500 mg m-2 on days 1, 8 and 15 in a 28-day cycle to 17 participants (Kindler et al, 2001). Only one minor regression and six cases of stable disease were reported in 13 assessable patients, with an overall median survival of 4.1 months. In contrast to these data, Bischoff et al, (1998) reported an encouraging response rate of 31% (5/16) with the same dose and schedule as the van Meerbeck study (gemcitabine 1250 mg m-2 on days 1, 8 and 15, every 28 days). Furthermore, seven additional patients reported a symptom relief via decreased pain or dyspnoea.
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.
Mesothelioma cancer research has been unable to produce an effective treatment modality for malignant mesothelioma.