Transarterial chemoperfusion shows promise in mesothelioma patients

By The Science Advisory Board staff writers

July 21, 2020 -- According to research presented during a recent virtual session of the Society of Interventional Radiology, there has been progress on a novel treatment for patients with advanced mesothelioma.

Mesothelioma is a rare and often fatal form of cancer that predominantly targets the lining of the lungs. The average life expectancy of those diagnosed with mesothelioma is typically 12-21 months after diagnosis. The disease is often diagnosed in the late stages due to a long latency period and tendency to be misdiagnosed as a number of less severe ailments. Because of the likelihood of a later prognosis, the five-year survival rate for people with mesothelioma is only 10% on average.

Once the cancer is confirmed, doctors will generally classify the disease into one of the four stages based on progression. Patients who receive a diagnosis around stage I or II have the most treatment options available. It is more commonly identified at stages III and IV where options become limited due to the metastasis to other parts of the body. However, as technology progresses, options for alternative types of care are becoming more widely accessible.

A new treatment called transarterial chemoperfusion (TACP) is not only safer and more effective than traditional methods but also may drastically improve the quality of life for patients who have few treatment options.

The procedure delivers chemotherapy agents into the arteries that supply blood to the diseased tissue. Unlike traditional chemotherapy options, where the drugs are circulated throughout the entire body, TACP delivers one-third of the cisplatin, methotrexate, and gemcitabine mixture into the internal mammary artery, which supplies the pleura within the lung. The other two-thirds of the mixture is then administered into the descending aorta, where it supplies the intercostal vessels, which also end up supplying the pleura.

Results of a phase II clinical study, conducted by the Moffitt Cancer Center, demonstrated a 70% disease control rate and median overall survival of 8.5 months from the start of the chemoperfusion treatment. The treatment also had a major complication rate of 1.4%, signifying it was well-tolerated by patients. The outpatient procedure usually only lasts an hour, followed by an additional hour of recovery, as opposed to some other chemotherapy procedures that can take as long as three to four hours at a time.

Another benefit of TACP is the lack of major side effects when compared to other chemotherapy treatments. When patients did report side effects, they were generally minor including mild nausea and chest pain, as opposed to the common memory loss, hair loss, mouth sores, and low blood cell count associated with traditional chemotherapy methods.

Currently, the Moffitt Cancer Center is the only treatment center in the U.S. offering the clinical trial with TACP for mesothelioma patients. However, the procedure is currently being used with mesothelioma patients in Germany and Egypt and is yielding even better results. Success with this procedure has also been found in other parts of the country in certain liver cancer patients.

As chemoperfusion clinical trials develop throughout the world, mesothelioma patients may soon see this procedure become available for their own treatment consideration.

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