Your doctors might recommend switching you to second-line chemotherapy. They’ll do this if the first-line chemotherapy they try on you doesn’t do the job of fully knocking down your mesothelioma.
But there’s a problem with second-line chemotherapy. It might not be any more successful than first-line chemotherapy when all is said and done.
Researchers in Greece recently took a close look at second-line chemotherapy. They did this to get a sense of just how well it actually does work for mesothelioma patients.
They came to the conclusion that second-line chemotherapy can help. However, they also concluded that effort needs to be made to find or develop drug combinations that do a better job than those currently available.
Writing in the Journal of Thoracic Oncology, the researchers issued a call for their colleagues around the world to redouble efforts aimed at improving second-line chemotherapies.
First-Line Mesothelioma Chemotherapy
First-line mesothelioma chemotherapy is simply any agent or combination of agents administered in an initial or primary regimen to fight this cancer.
The agents administered and the regimen employed will be those generally accepted by the medical establishment. Pemetrexed and cisplatin together is considered the gold standard for first-line mesothelioma chemotherapy.
There isn’t really a gold standard for second-line mesothelioma chemotherapy. However, agents commonly used include taxane, gemcitabine and docetaxel.
Doctors resort to those when it becomes necessary to halt first-line chemotherapy. One reason for halting it is that you can’t tolerate the drugs. A more common reason for halting first-line chemotherapy is that it isn’t working as well as hoped.
For these reasons, having good second-line chemotherapy options is important, the Greek researchers point out.
The researchers developed their ideas about second-line chemotherapy by retrospectively analyzing the treatment records of their medical center’s own malignant mesothelioma patients. Their medical center is part of the University of Athens.
“In these patients, we documented demographics, asbestos exposure, histological subtype, involvement of pleura or peritoneum, Eastern Cooperative Oncology Group performance status, chemotherapy lines and agents, cycles of chemotherapy received and date of death,” the researchers wrote.
Of those 98 patients, 50 required second-line chemotherapy. The researchers said they documented those patients’ performance status beginning with the initiation of second-line chemotherapy.
The researchers documented the second-line chemotherapy patients’ best response. They then calculated overall survival from the time of diagnosis, survival from initiation of the second-line chemotherapy and progression-free survival from the point at which that secondary treatment ended.
Second-Line Mesothelioma Chemotherapy Used on Almost Half of the Patients
According to the researchers, 48 percent of the second-line mesothelioma chemotherapy recipients had been treated with a combination of taxane and gemcitabine.
None of that group saw even a partial response to the treatment. However, it did keep nearly 22 percent of them in disease-stable condition. The median time for which this group enjoyed progression-free survival was just under three months.
Another portion of the 50 patients who received second-line chemotherapy were treated with docetaxel alone. This subgroup amounted to 18 percent of the total.
As with the taxane and gemcitabine cohort, no one achieved partial response. The difference here was that no one in the docetaxel arm achieved disease-stable condition either.
The remainder of the 50 patients had been given first-line chemotherapy drugs as their second-line treatment. Just over 14 percent of them achieved partial response and 57 percent achieved disease stability.
The title of the research article is “212P: 2nd Line Chemotherapy in Malignant Mesothelioma: A Center’s Experience.”