Clinicians should use transarterial chemoperfusion for managing MPM (malignant pleural mesothelioma) patients. It is a safe, effective, and reliable treatment approach.
During a virtual session of the Society of Interventional Radiology’s 2020 Annual Scientific Meeting held on 14 June 2020, a research abstract illustrated that for management of MPM patients, treatment with transarterial chemoperfusion is beneficial for extending the lives of patients who have few or no remaining treatment options. It has minimal side effects.
MPM is a rare and deleterious cancer of the protective pleural membranes surrounding the lungs. Its treatment is very challenging. Treatment of advanced mesothelioma via transarterial chemoperfusion is a safe and effective treatment approach. It may enhance the quality of life for patients having limited treatment options.
A survival rate of around 12 months from diagnosis of cancer is witnessed in patients with stage 3 and 4 MPM. However, this novel approach helps to extend the patients’ lives, thus offering them more time with their friends and family.
A total of 27 MPM patients were recruited in a Phase II clinical trial. All the enrolled participants underwent chemoperfusion. All the patients were previously given chemotherapy. Multiple rounds of chemotherapy were given to many patients. About four patients were previously treated with radiation therapy and three patients were given pleurectomy. Before recruitment, all the patients continued to have disease progression.
Transarterial chemoperfusion yields a relatively higher drug concentration to the infected tissue in the lung’s membrane. This helps to enhance the treatment effect by mitigating the side effects. In this approach, about one-third of the chemotherapy combination of methotrexate, cisplatin, and gemcitabine is directly injected into the internal mammary artery that supplies the lung’s membrane lining.
The other two-thirds of the combination regimen is delivered into the descending aorta that also reaches the pleural membrane. This is in contrast with other chemotherapy that is intravenously injected and disseminates through the entire body. The treatment is an outpatient technique that lasts for one hour, followed by a one-hour recovery.
The interim results of the study illustrated a 70.3 % disease control rate. From the initiation of the chemoperfusion treatment, the median overall survival rate was found to be 8.5 months. All the patients effectively tolerated the treatment. Patients witnessed a major complication rate of 1.4 %. Minor side effects from the treatment such as mild nausea and chest pain were witnessed. This treatment is devoid of the side effects noted during treatment with conventional intravenous chemotherapy.
For alleviating MPM, surgery is currently the most effective treatment option. However, surgery is only possible with early detection. Unfortunately, about 10-20 % of patients are candidates for surgery and frequently face surgical complications.
The researchers should focus on broadening their study to other cancer centers with a larger number of patients suffering from MPM. More flexibility may be added to the analysis to allow for elevating the dosage and modifying the combination of medications for individual patients. This will aid in exploring whether either approach could further boost the study outcomes.