A Phase 2 pleural mesothelioma clinical trial uses lung-sparing surgery along with chemotherapy and radiation. Fortunately, it’s available to a wide range of patients — from Stage 1 to Stage 3 of the rare cancer.
The Memorial Sloan Kettering Cancer Center is running the study, which uses surgery before chemotherapy and radiation. Surgery, chemotherapy and radiation are the three primary treatments for pleural mesothelioma, which forms in the narrow space separating chest wall and lung cavity.
The clinical trial is currently recruiting patients and has locations (aside from Memorial Sloan Kettering) throughout the country, including:
- Moffitt Cancer Center (Tampa, Florida)
- Brigham and Women’s Hospital (Boston, Massachusetts)
- Mayo Clinic (Rochester, Minnesota)
- M.D. Anderson Cancer Center (Houston, Texas)
How the Clinical Trial Works
Mesothelioma surgery involves removal of body parts where the tumors formed or spread. These areas could include the pleura (where pleural mesothelioma originates), diaphragm, pericardium and affected lung.
The Memorial Sloan-Kettering trial will use pleurectomy with decortication. This surgery removes the pleura and possibly the diaphragm and pericardium, but it spares the lung.
Adjuvant Mesothelioma Treatment
The next phase is mesothelioma chemotherapy, which will be administered between four and eight weeks following the surgery. Other details of this step of the study are as follows:
- Patients will receive two chemotherapy drugs intravenously.
- This treatment involves four sessions, with each occurring 21 days apart.
- Each session includes patients receiving pemetrexed for 10 minutes and either cisplatin for 60 minutes or carboplatin for 30 minutes.
When chemotherapy is administered after the main treatment — in this case, surgery — it’s considered “adjuvant chemotherapy.” Since mesothelioma tumors are microscopic and often invisible to the naked eye, surgeons usually can’t remove all of the disease. Adjuvant chemotherapy attacks these remnant cells.
Additionally, since pleurectomy with decortication does not remove the lung, adjuvant chemotherapy can address any tumors that have spread to this organ.
Intensity-modulated radiation therapy is the final part of the clinical trial’s treatment method. Between four and eight weeks after chemotherapy treatment ends, medical experts will use high-energy beams to target the remaining diseased cells. Patients will undergo 28 intensity-modulated radiation therapy sessions over six weeks.
Mesothelioma radiation could be used before or after surgery or chemotherapy. This study’s researchers believe administering radiation therapy as the last step may help kill those remaining mesothelioma cells not addressed during surgery or chemotherapy.
At the very least, they hope to shrink the tumors enough to where the disease is contained and no longer spreading. Many mesothelioma patients can live for years with the disease in this “dormant” phase.
Criteria for Qualification
The clinical trial has numerous inclusion and exclusion criteria. One is that patients must have a primarily epithelioid pleural mesothelioma cell type. Patients also cannot have had any intrapleural therapy (aside from pleurodesis).
We at Mesothelioma Guide can explain the remaining criteria for enrolling in the study. Our patient advocate, Jenna Campagna, is available by email at email@example.com to answer any questions. Additionally, she can provide a list of other mesothelioma clinical trials. If you’re unable to participate in this one, there could be another study available to you.
- Surgery, Chemotherapy, and Intensity Modulated Radiation Therapy in Treating Patients with Stage I-III Pleural Mesothelioma. National Cancer Institute. Retrieved from: https://www.cancer.gov/about-cancer/treatment/clinical-trials/search/v?id=NCI-2016-01016&r=1. Accessed: 12/09/19.
Sources & Author