Standard cancer treatments simply don’t cut it for patients with advanced cases of mesothelioma.

That’s the assessment of a team of researchers tracking real-world care for mesothelioma patients. The group argued that “more effective” systemic anti-cancer therapies are needed to treat advanced mesothelioma cases, based on the limited efficacy of standard cancer treatments encountered in their observational study.

The team — which included an oncologist from Oncology Hematology Care in Cincinnati and corporate researchers from Bristol Myers Squibb and McKesson Life Sciences — published their findings March 26 in the journal Future Oncology.

Real-World Results

For the study, the group focused on advanced mesothelioma treatment at community centers. This approach was intended to reflect real-world mesothelioma care, which researchers have “limited information” on compared to heavily stratified-patient data in clinical settings, the team noted.

The team reviewed 469 cases out of 2,697 patients diagnosed with malignant mesothelioma. They noted that fewer than half of those nearly 2,700 received any kind of systemic anti-cancer therapy.

Among the study group, 369 patients (78.7 percent) were given a chemotherapy cocktail of pemetrexed, which goes by the brand name Altima, and one of several platinum-based doublet drugs. Another 51 patients (10.9 percent) were administered only pemetrexed.

Subsequent Treatments

The majority of these advanced mesothelioma patients received only first-line chemotherapy, with only 23 percent getting second-line therapies, and another 7 percent opting for second- and third-line treatments.

Of those who got second-line chemotherapy, most received either gemcitabine (branded as Gemzar) or pemetrexed. A small number of participants did receive immunotherapy, however.

Of the few that received third-line chemotherapy, most got gemcitabine, pemetrexed, or vinorelbine (branded as Navelbine), the researchers noted.

Survival Data

However, all these different treatments yielded fairly poor results. Median overall survival for patients that received any first-line treatment was 12 months, with patients under 65 living 14.9 months, those between 65 and 75 living 11.6 months, and those over 75 years of age surviving 11.8 months.

For patients that received pemetrexed and a platinum-based drug, median overall survival was 14 months. Those who got pemetrexed alone lived an average of 10.7 months.

The numbers were only slightly better for patients who opted for second-line chemotherapy, with them averaging 6.4 additional months. Median overall survival with gemcitabine was 3.4 additional months, 8.4 extra months for those on pemetrexed and 11.8 additional months for the handful of patients that received immunotherapy.

Based on these figures, the group determined that the current crop of systemic anti-cancer therapies for advanced mesothelioma “were associated with poor [overall survival] across all lines of therapy, highlighting the need for more effective treatments.” They also noted their disappointment that “only a small proportion of patients” received second- or third-line treatments.

“Investigation of additional therapies for advanced [malignant pleural mesothelioma], including immunotherapy, is warranted,” they concluded.

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