Transarterial chemoperfusion treatment shows very promising and effective results in the treatment of mesothelioma, a devastating cancer of the pleura, the membranes that surround the lungs.
Malignant pleural mesothelioma (MPM) is a very aggressive primary tumor of the pleura for which there is no cure. This cancer is mainly caused by exposure to asbestos, and the first symptoms may appear up to 40 years after the first contact with the material. There are between 2,400 and 2,800 new cases in the US each year.
Extension of life expectancy
Researchers at Moffitt Cancer Center in Tampa have developed a new treatment that improves patients’ quality of life. They presented their results in a virtual session at the Society of Interventional Radiology’s annual scientific conference 2020 on June 14. “The typical survival rate for patients in stages 3 and 4 of MPM is about 12 months after diagnosis,” said Bela Kis, the study’s principal investigator and an interventional radiologist at Moffitt Cancer Center in Tampa. But with this new treatment, we hope to extend patients’ lives beyond that, giving them more time with their friends and family.
The new treatment is transarterial chemoperfusion. It provides the diseased tissues of the lung mucosa with a relatively high concentration of drugs to maximize the effect of the treatment by limiting side effects. Unlike other intravenous chemotherapies that circulate throughout the body, interventional radiologists inject one-third of the chemotherapy cocktail, which contains cisplatin, methotrexate, and gemcitabine, directly into the internal mammary artery that feeds the pleura. The other two-thirds are injected into the descending aorta, which extends to the intercostal vessels that also supply the pleura.
Fewer side effects
The study was conducted on 27 patients with MPM who received transarterial chemoperfusion. treatment. These patients have previously received chemotherapy, radiation therapy, or pleurectomy, but none of these treatments have been successful in stopping the disease. Thanks to the new treatment, the disease control rate is 70.3% with a survival rate that increases to 8.5 months from the start of the chemoperfusion. Treatment was well tolerated by patients with a complication rate of less than 1.4% and most side effects were relatively minor, including mild nausea and chest pain. “We were pleasantly surprised to see that this treatment does not have the same side effects as traditional intravenous chemotherapy,” said Bela Kis. Seeing these promising results with so few side effects means we can positively influence the quality of life of these patients.
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Researchers are striving to expand their study to other cancer centers with larger numbers of MPM patients. They also hope to make the study more flexible so that the dose can be increased and the drug combination changed for each patient, to see if both approaches can further improve outcomes.