Trimodality Therapy May Increase Mesothelioma Survival Times

A recent publication in the Journal of Clinical Oncology has demonstrated that a three-pronged approach to the treatment of the rare but aggressive cancer mesothelioma – called trimodality therapy – may improve the survival times of patients.
A team of scientists, headed by Lee M. Krug, at the Memorial Sloan-Kettering Cancer Center in New York City followed the treatment of 77 patients diagnosed with Stage I through Stage III mesothelioma. Patients had had no previous surgery, displayed adequate lung function, and were either fully active or restricted only from strenuous activity. The study was part of a Phase II clinical trial to assess the efficacy of combating mesothelioma with a three-part treatment consisting of chemotherapy, surgery and radiation therapy.

Mesothelioma, a rare cancer of the lining that surrounds the lungs, heart and stomach, is caused by asbestos exposure. The disease commonly affects lung function, so its symptoms can be easily confused with other lung-related diseases, such as emphysema and tuberculosis. This makes mesothelioma difficult to diagnose until the later stages of the disease. Once treatment starts, the cancer has usually already taken hold, and carries a poor prognosis.

Krug and his associates first administered chemotherapy to all of the patients. After completion, several showed a pathological complete response – the disappearance of all clinical symptoms. It’s important to note that this does not mean that the cancer was cured, since some mesothelioma cells still remained without displaying symptoms. Fifty-four patients then went on to undergo surgery to remove the diseased parts of their lungs, diaphragm and lung lining. Forty-four of these patients then followed their surgery with radiation therapy.

Patients who had completed all three levels of therapy showed a median survival time of 29.1 months, and a two-year survival rate of 61.2%. For comparison, the median survival rate of all the patients in the study – including those that only had one or two rounds of treatment – was 17 months.

Based on this study, trimodality therapy might be an effective way to treat mesothelioma patients in order to extend their lives.