This is a poorly kept secret by now, but it’s still true: We need new therapies for mesothelioma.
A study in Future Oncology examined 469 cases of malignant pleural mesothelioma. All the cases involved at least one line of therapy, usually chemotherapy, while a few involved second- and even third-line treatment.
The survival rates range from a few months to a couple of years, which is standard for most mesothelioma studies. Most patients (361) only received one regimen of therapy, and the survival rates barely topped one year.
This is indicative of a push for immunotherapy and other emerging treatments as a first-line option.
One promising note from the study is how well immunotherapy fared as a second-line option.
Study Shows Need for Other Therapies
The study included patients diagnosed from 2008-2016. There initially were nearly 3,000 patients, but many did not receive any therapy. Some were excluded due to age, clinical trial participation, another cancer diagnosis or lack of mesothelioma metastasis. This reduced the field to 469 cases.
The median age was 71-72 and 82% were males. Of the 469 cases receiving first-line treatment:
- 369 received either a chemotherapy combination of pemetrexed with cisplatin or pemetrexed with carboplatin
- 51 had pemetrexed alone
- 35 had another chemotherapy cocktail (involving gemcitabine, vinorelbine and bevacizumab)
The one-year survival rate for the whole study was 33%, a number brought down by patients receiving alternative chemotherapy options. For the pemetrexed and cisplatin or pemetrexed and carboplatin groups:
- The median survival was 13.7 and 14.2 months, respectively
- The one-year survival rates were 54.2% and 55.1%, respectively
- The two-year survival rates were 32.2% and 32.7%, respectively
“There is a need for more effective (first-line systemic anticancer therapies) for advanced malignant pleural mesothelioma,” the authors wrote.
Immunotherapy Improves Survival After Initial Chemotherapy
Only 108 patients received second-line therapy, accounting for less than 25% of the study population.
Chemotherapy performed poorly as a second-line treatment:
- The median survival was 3-8 months depending on the chemotherapy drug
- The one-year survival rate was around 20%.
Immunotherapy, however, performed exceptionally well by comparison. Checkpoint inhibitor drugs had a median survival of 11 months as a second-line treatment, meaning patients lived for 11 months following the start of the regimen. This is in addition to their survival after first-line therapy.
The one-year survival rate was 50%. While only nine patients received immunotherapy, it’s still a positive result.
The United States Food and Drug Administration approved Opdivo and Yervoy for mesothelioma. The two immunotherapy drugs improve survival as a first-line therapy compared to chemotherapy. The second-line benefit only affirms the needed push for immunotherapy in all cancer centers.
If you have mesothelioma and are interested in starting immunotherapy, contact our staff. Registered nurse Karen Ritter can help you through the process of finding a cancer center. Email her at email@example.com.
Sources & Author
- Treatment patterns and outcomes of patients with advanced malignant pleural mesothelioma in a community practice setting. Future Oncology. Retrieved from: https://www.futuremedicine.com/doi/10.2217/fon-2021-0047?url_ver=Z39.88-2003&rfr_id=ori%3Arid%3Acrossref.org&rfr_dat=cr_pub++0pubmed. Accessed: 03/30/2021.
Sources & Author