During a phase II study, surgeons discovered that infusing chemotherapy drugs in an isolated area may help improve the overall survival of malignant pleural mesothelioma patients. Surgeons in Burghausen, Germany, believe that this could be a new treatment option for advanced pleural mesothelioma patients.
Receiving Isolated Chemotherapy and Chemofiltration
During the study, patients received isolated thoracic perfusion with chemofiltration (ITP-F), in hopes that it would improve their overall quality of life (QoL). Surgeons also anticipated that this process would decrease the chances of damaging healthy tissue.
The study consisted of 28 patients with epithelioid mesothelioma. 25 of the patients were male and 3 were female. Cases of mesothelioma are more common in men than they are in women.
Patients in the study had a mean age of 63.4 years old. Typically, 9 out of 10 mesothelioma diagnoses affects someone that is over the age of 60.
Prior to the study
10 patients had received systemic chemotherapy
5 patients had undergone surgery
5 patients had received radiation
For isolated thoracic perfusion, under anesthesia, patients had a stop-flow balloon catheter inserted via a femoral access. To prevent systemic toxicity, the inferior vena cava and aorta were blocked at the diaphragm and cuffs were placed around the upper arms. Chemotherapy of cisplatin and mitoxantrone was then injected directly into the aorta. After 15 minutes the blocks were released and each patient experienced around 45 minutes of chemofiltration to help filter out most of the toxic drugs.
Drugs Involved in the Study
Here is some brief information about the chemotherapy drugs that were involved in the study.
Cisplatin – is an alkylating agent. It works by damaging the DNA in a cell, which makes the cell unable to reproduce. Cisplatin is commonly used by IV for treating mesothelioma.
Mitoxantrone – is an antitumor antibiotic. It works by interfering with the DNA in cells. By doing this it blocks the cells from growing.
Some side effects associated with chemofiltration are
Low white blood cell count
Low platelet count
162 cycles of treatment were completed during the study. Patients did not experience any high levels of toxicity, due to chemofiltration. In fact, no gastrointestinal toxicity or neurotoxicity was observed.
QoL or overall survival rate of the patients was
1 year = 49%
2 and 3 years = 31%
5 years = 18%
The surgeons discovered that the median overall survival rate of the patients was 12 months. The median overall progression-free survival was 9 months.