NEW YORK (Reuters Health) Jan 10 - New chemotherapy combinations have prolonged the median survival of patients with malignant mesothelioma by only a few months, researchers from The Netherlands have found.
As reported online December 1 in the European Respiratory Journal, Dr. R. A. Damhuis from the Rotterdam Cancer Registry and colleagues assess the use of chemotherapy in 4731 patients treated for malignant mesothelioma between 1995 and 2006, and its impact on their survival.
"Response to single-agent or combination chemotherapy used to be limited until a novel agent was introduced, pemetrexed, that showed a response rate of 32% in combination with carboplatin," the researchers note. Early reports of pemetrexed started appearing around 2002.
Indeed, they found, chemotherapy use increased from 8% (in 1995-1998) to 36% (in 2005-2006). Only 11% of 70- to 79-year-olds and only 3% of patients 80 years and older received chemotherapy, however.
At the same time, median survival increased over time from 7.1 to 9.2 months. With chemotherapy, median survival increased from 10.1 to 13.3 months. (But, the authors point out, "By definition, chemotherapy patients cannot die between diagnosis and their first cycle, hence getting a survival head start.)
The survival difference with chemotherapy faded after controlling for age and tumor type, the researchers note.
Median survival was markedly lower for peritoneal vs pleural mesothelioma (3.9 vs 8.1 months). Male gender and older age predicted worse survival in peritoneal mesothelioma, whereas younger age, epithelioid tumor type, and chemotherapy in the latter periods predicted better survival in pleural mesothelioma.
"Despite introduction of novel chemotherapy regimens," the investigators conclude, "malignant mesothelioma is still a fatal disease with a median prognosis of less than a year. With disease incidence at its peak, now is the time to test new treatment options, preferably in randomized controlled trials."
"Within 10 years, the number of mesothelioma patients will decrease and the aging of the patient population will make them less suitable for inclusion in trials with toxic treatment," they add. "Quality of life should be a major endpoint in these trials, and prevention remains the best option to decrease mortality from mesothelioma."
SOURCE: http://bit.ly/yt6Rdp
Eur Resp J 2011.
As reported online December 1 in the European Respiratory Journal, Dr. R. A. Damhuis from the Rotterdam Cancer Registry and colleagues assess the use of chemotherapy in 4731 patients treated for malignant mesothelioma between 1995 and 2006, and its impact on their survival.
"Response to single-agent or combination chemotherapy used to be limited until a novel agent was introduced, pemetrexed, that showed a response rate of 32% in combination with carboplatin," the researchers note. Early reports of pemetrexed started appearing around 2002.
Indeed, they found, chemotherapy use increased from 8% (in 1995-1998) to 36% (in 2005-2006). Only 11% of 70- to 79-year-olds and only 3% of patients 80 years and older received chemotherapy, however.
At the same time, median survival increased over time from 7.1 to 9.2 months. With chemotherapy, median survival increased from 10.1 to 13.3 months. (But, the authors point out, "By definition, chemotherapy patients cannot die between diagnosis and their first cycle, hence getting a survival head start.)
The survival difference with chemotherapy faded after controlling for age and tumor type, the researchers note.
Median survival was markedly lower for peritoneal vs pleural mesothelioma (3.9 vs 8.1 months). Male gender and older age predicted worse survival in peritoneal mesothelioma, whereas younger age, epithelioid tumor type, and chemotherapy in the latter periods predicted better survival in pleural mesothelioma.
"Despite introduction of novel chemotherapy regimens," the investigators conclude, "malignant mesothelioma is still a fatal disease with a median prognosis of less than a year. With disease incidence at its peak, now is the time to test new treatment options, preferably in randomized controlled trials."
"Within 10 years, the number of mesothelioma patients will decrease and the aging of the patient population will make them less suitable for inclusion in trials with toxic treatment," they add. "Quality of life should be a major endpoint in these trials, and prevention remains the best option to decrease mortality from mesothelioma."
SOURCE: http://bit.ly/yt6Rdp
Eur Resp J 2011.
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