Study Says Ascites Can Impact Mesothelioma Treatment Response, According to Surviving Mesothelioma

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Researchers recommend that drug choice be guided by aspects of the patient’s condition.

Selection of chemotherapy based on the patient’s condition...might be important for advanced peritoneal mesothelioma.

Surviving Mesothelioma is reporting on newly published research suggesting that certain aspects of a peritoneal mesothelioma patient’s condition may have an impact on the toxicity of chemotherapy.

A combination of pemetrexed (Alimta) and a platinum-based drug like cisplatin or carboplatin is the drug treatment of choice for patients with pleural mesothelioma, the most common form of the disease. But in an article in Anticancer Research, a team of Japanese researchers points out that peritoneal mesothelioma, which grows in the lining of the abdomen, differs from pleural mesothelioma at the cellular level and may need a different approach.

The small retrospective study focused on six peritoneal mesothelioma patients diagnosed at four different institutions. The patients all had some amount of ascites, a buildup of fluid in the abdomen which is a common side effect of peritoneal mesothelioma and other abdominal cancers. The patients were all treated with the pemetrexed/cisplatin or carboplatin chemotherapy combination.

The three peritoneal mesothelioma patients who experienced the best response to the treatment were those with the least amount of ascites. One of these patients had a partial response to chemotherapy, meaning that it killed at least some cancer cells. In the other two low-ascites patients, the pemetrexed-based chemotherapy stabilized their disease.

But patients with what was described as “massive ascites” did not respond nearly as well. Although the treatment was found to be safer when levels of the platinum-based drug were reduced, two of the three high-ascites patients experienced serious blood-related toxicity. Median progression-free survival for all study subjects was 7.2 months and overall survival was 13.1 months. Writing on their findings in Anticancer Research, the authors conclude, “Selection of chemotherapy based on the patient’s condition, such as ascites, might be important for advanced peritoneal mesothelioma.”

Peritoneal mesothelioma accounts for about a third of all mesothelioma cases. All types of mesothelioma are caused by exposure to asbestos. About 2,500 Americans are diagnosed with the disease each year.

The original study of chemotherapy for peritoneal mesothelioma appears in Anticancer Research. (Nakano, M, et al, “Pemetrexed combined with Platinum-based chemotherapy for advanced malignant peritoneal mesothelioma: Retrospective analysis of six cases”, January, 2014, Anticancer Research, pp. 215-220,

For nearly ten years, Surviving Mesothelioma has brought readers the most important and ground-breaking 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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