Study Finds Second-Line Chemotherapy Drug “Moderately Active” for Mesothelioma, According to Surviving Mesothelioma

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Scientists in Italy say vinorelbine may be a promising option for patients whose cancer returns after chemotherapy.

Almost half of the mesothelioma patients in the study (49.1%) saw either partial response or stabilized disease.

The anti-mitotic drug vinorelbine may be a safe and effective treatment for mesothelioma patients whose cancer progresses after first-line chemotherapy with the standard drugs. Pemetrexed (Alimta) is the primary first-line chemotherapy drug for mesothelioma patients with unresectable disease. The drug is usually paired with a platinum-based agent like cisplatin.

But there is little information in the medical literature about what to do when first-line mesothelioma treatment does not work. Vinorelbine, a drug derived from the rosy periwinkle and marketed under the brand name Navelbine, may be a safe and effective choice, according to a new study published in the journal Lung Cancer.

Fifty-nine mesothelioma patients were included in the retrospective Italian study. Their median age was 69 and all had received at least one round of pemetrexed-based chemotherapy. Patients were given 25mg/m2 of vinorelbine intravenously every three weeks for a maximum of 6 cycles. Treatment stopped when a mesothelioma tumor began growing again or when the side effects became too severe.

The best news is that almost half of the mesothelioma patients in the study (49.1%) saw either partial response or stabilized disease as a result of vinorelbine treatment. Overall survival was 6.2 months. Patients who had the best response were those who had a high ECOG performance status, a measure of cancer patients’ general well-being, and those who had experienced at least six months of progression-free survival after their first-line chemotherapy.

Just as importantly, vinorelbine was well-tolerated by most of the mesothelioma patients. Only five patients experienced grade 3 or 4 neutropenia, a sharp decline in the white blood cells called neutrophils. For most patients, the most bothersome effects of vinorelbine treatment were fatigue and constipation.

“Vinorelbine was moderately active in pemetrexed-pretreated malignant pleural mesothelioma patients with an acceptable toxicity profile,” the researchers conclude in the journal Lung Cancer. (Zucali, PA, et al, Vinorelbine in pemetrexed-pretreated patients with malignant pleural mesothelioma”, November 20, 2013, Lung Cancer, Epub ahead of print.

For nearly ten years, Surviving Mesothelioma has brought readers the most important and groundbreaking news on the causes, diagnosis and treatment of mesothelioma. All Surviving Mesothelioma news is gathered and reported directly from the peer-reviewed medical literature. Written for patients and their loved ones, Surviving Mesothelioma news helps families make more informed decisions.

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Michael Ellis
Cancer Monthy
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