Transarterial chemoperfusion shows promise for mesothelioma patients
A novel treatment for advanced mesothelioma is safe and effective and may
improve the quality of life for patients who have few treatment options,
according to a research abstract presented during a virtual session of the
Society of Interventional Radiology's 2020 Annual Scientific Meeting on June
14. Transarterial chemoperfusion treatment for malignant pleural mesothelioma
(MPM) comes with minimal side effects and shows promise for extending the lives
of patients who have limited or no remaining treatment options.
"MPM is a devastating cancer of the pleura, the membranes surrounding the lungs, that is very difficult to treat," said Bela Kis, MD, PhD, the principal investigator on the study and an interventional radiologist at the Moffitt Cancer Center in Tampa. "The typical survival rate of patients with stage 3 and 4 MPM is around 12 months from diagnosis; but with this new treatment, we are hoping we might be able to extend patients' lives beyond that--giving them more time with friends and family."
Twenty-seven patients with MPM were enrolled in the Phase II clinical trial and underwent chemoperfusion treatment. All patients had received prior chemotherapy, many of whom received multiple lines of chemotherapy. Four of the patients had prior radiation therapy and three patients had pleurectomy. All continued to have disease progression before enrollment.
"MPM is a devastating cancer of the pleura, the membranes surrounding the lungs, that is very difficult to treat," said Bela Kis, MD, PhD, the principal investigator on the study and an interventional radiologist at the Moffitt Cancer Center in Tampa. "The typical survival rate of patients with stage 3 and 4 MPM is around 12 months from diagnosis; but with this new treatment, we are hoping we might be able to extend patients' lives beyond that--giving them more time with friends and family."
Twenty-seven patients with MPM were enrolled in the Phase II clinical trial and underwent chemoperfusion treatment. All patients had received prior chemotherapy, many of whom received multiple lines of chemotherapy. Four of the patients had prior radiation therapy and three patients had pleurectomy. All continued to have disease progression before enrollment.
Transarterial
chemoperfusion delivers a relatively high concentration of drugs to diseased
tissue in the lining of the lungs to maximize the treatment effect with limited
side effects. Unlike other chemotherapy that is delivered intravenously and
circulates through the entire body, interventional radiologists inject
one-third of the chemotherapy cocktail of cisplatin, methotrexate, and
gemcitabine directly into the internal mammary artery that supplies the pleura.
The other two-thirds of the drugs are injected into the descending aorta, which
reaches the intercostal vessels that also supply the pleura. The treatment is
an outpatient procedure and typically lasts an hour, followed by a one-hour
recovery.
The interim results of the study
show 70.3 percent disease control rate and median overall survival rate of 8.5
months from the start of the chemoperfusion treatment. The treatment was
well-tolerated by patients with a major complication rate of 1.4 percent. Most
side effects were relatively minor, including mild nausea and chest pain.
"We were pleasantly surprised
to find that this treatment doesn't come with the same side effects of
traditional intravenous chemotherapy," said Kis. "To see these
promising results with so few side effects means we are able to make a positive
impact on quality of life for these patients."
Currently, surgery is the only truly
effective treatment for MPM, but the disease must be diagnosed early. Unfortunately,
only 10 to 20 percent of patients are candidates for surgery and often
experience surgical complications. The researchers are looking to expand their
study to other cancer centers with larger MPM patient populations, since the
cancer is so rare. They also hope to add flexibility to the study to allow for
increasing the dosage and changing the combination of medications for
individual patients to determine whether either approach could further improve
outcomes.
Additional information about the clinical
trial is available at ClinicalTrials.gov, using the identifier NCT02611037
The research was originally scheduled to be presented in person at SIR's Annual Scientific Meeting, March 28-April 2, in Seattle before the meeting was canceled due to COVID-19 concerns. Visit sirmeeting.org for the latest information.