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Second-Line Chemotherapy for Mesothelioma: Worth the Risk?

by anonymous

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Mesothelioma is a rare but aggressive cancer of internal membranes, most often the pleural membrane around the lungs or the peritoneal membrane lining the abdomen. Although mesothelioma is resistant to most standard treatments, chemotherapy remains the top first-line treatment option. Clinical studies have found that, in most cases, it is able to extend life by a few months. The odds improve somewhat for mesothelioma patients who are treated with multiple modalities.

But there is controversy as to whether or not chemotherapy should be used again in patients whose mesothelioma returns after first-line chemotherapy. While they attack cancer cells, chemotherapy drugs also weaken the body overall and cause of host of serious side effects, causing clinicians to wonder if a second round of chemotherapy is worth the risk in certain mesothelioma patients.

A new Turkish study of second-line chemotherapy treatment (SLCT) suggests that the answer should be ‘no’. The study included 51 malignant pleural mesothelioma patients from a Turkish hospital. All patients in the study received chemotherapy as a first-line treatment. The overall survival of patients who received SLCT when their tumors began to grow again was compared with that of patients who received only best supportive care (BSC). BSC includes treatments designed to manage symptoms, but excludes those directed at shrinking the cancer itself.

The median overall survival for patients who had both first- and second-line chemotherapy was 20.3 months. These patients had a median survival after the start of their SLCT of 5.9 months. In contrast, patients who had only BSC after first-line chemotherapy had an overall survival of 14.7 months. These patients had a median overall survival of 4.7 months from the end of their first-line chemotherapy.

Although these figures seem to show what the study’s authors call a “trend for improvement” among patients who had SLCT, they point out that the differences were not great enough to be statistically significant. Because patients must be deemed healthy enough for second-line chemotherapy, the patients who had BSC instead may have been sicker to start with. The authors conclude that their results “do not support the proposal that second-line chemotherapy could be effective in patients with malignant pleural mesothelioma”. Their findings appear in a recent issue of the Asian Pacific Journal of Cancer Prevention.

Disclaimer: The information in this article is for educational and informational purposes only. The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read in this article. This article was written by a third party and its content reflects the views of the third party.


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