At the 14th International Conference of the International Mesothelioma Interest Group (iMig) held in Ottawa, Canada early this month, researchers presented the results of both ongoing and completed research; there was a mesothelioma clinical trial on almost every issue relating to mesothelioma treatment and care.
One mesothelioma clinical trial featured at the conference is an effort to compile data on best practices for multimodal mesothelioma treatment. This mesothelioma clinical trial received an iMig 2018 Young Investigators Award, a program sponsored by Kazan Law. This clinical trial is a Phase II randomized study of pleurectomy/decortication (P/D) surgery in combination with chemotherapy for patients with early stage malignant pleural mesothelioma.
While this multimodal treatment is commonly prescribed for patients with pleural mesothelioma, the data on whether chemotherapy is more effective if administered before or after surgery is lacking. This promising mesothelioma clinical trial hopes to fill a gap in knowledge that will help doctors provide better treatment for their pleural mesothelioma patients.
Mesothelioma Clinical Trial Gathers Data on Surgery Plus Chemotherapy
The multimodal treatment mesothelioma clinical trial, led by Jo Raskin, a fellow at Antwerp University Hospital, Belgium, is in its early stages. It has enrolled 10 patients so far at two sites, and is in the process of enrolling additional patients at four more sites throughout Belgium.
To be eligible for this mesothelioma clinical trial, participants must have an early stage diagnosis of pleural mesothelioma, be in good enough health to tolerate surgery and chemotherapy, and have had no previous treatment. Patients with tumors of all three cell types can participate in the study.
The patients will be divided into two groups. In Arm A, participants receive surgery immediately, with three cycles of chemotherapy afterward. The chemotherapy regimen is two-drug combination: cisplatin plus pemetrexed. Arm B will receive the three cycles of chemotherapy first, followed by surgery.
The combination of surgery and chemotherapy has already been proven to prolong life expectancy in pleural mesothelioma patients. This enterprising team of young researchers wants to add evidence-based advice on which order of treatment produces the best results.
This research isn’t as glamorous as immunotherapy studies, which hold the tantalizing promise of a mesothelioma cure. The outcomes of immunotherapy studies are uncertain, however. Research like this study is likely to provide immediate benefits for mesothelioma patients in treatment now. Effective multimodal treatment can add months and even years to the survival time of a mesothelioma patient; that is valuable time mesothelioma families can have to spend together.
Mesothelioma Surgery Procedures
For their study, the Belgian researchers chose to focus solely on P/D surgery. Although extrapleural pneumonectomy (EPP) is a more common surgery for pleural mesothelioma, their review of past studies convinced them that the risks of EPP outweigh the benefits. For their mesothelioma clinical trial to develop a recommended treatment protocol, they chose the surgery most likely to produce a positive outcome.
To remove as much cancerous tissue as possible, EPP surgery takes a radical approach. The procedure removes the affected lung, leaving patients with a single lung. In addition, this surgery takes out the pleura (the thin lining around the lungs, where mesothelioma tumors form), plus part of all of the spleen.
By contrast, P/D, which is called lung-sparing surgery, removes the pleura but leaves both lungs intact. During the P/D procedure, the surgeon exposes the affected lung and carefully removes any cancerous growths on the lung surface. This is the decortication part of the operation.
Both EPP and P/D are major surgeries with lengthy recovery time, but the preservation of both lungs in P/D makes it easier for patients to get back on their feet after surgery. Previous studies cited by the research team found that EPP was associated with significant complications and risks. Research has shown better results with P/D, so this mesothelioma clinical trial prescribes the evidence-based better surgical treatment for pleural mesothelioma patients.
Multimodal Treatment for Mesothelioma
Doctors have found that multimodal treatments often provide better outcomes for mesothelioma patients. The current standard of care treatments for mesothelioma are surgery, chemotherapy, and radiation.
Almost all mesothelioma patients receive chemotherapy. The drug combination used by the researchers in the Belgian study is the one that has been found to be effective: pemetrexed plus a platinum drug (usually either cisplatin or carboplatin).
For some mesothelioma patients, surgery may be too hard to take. In that case, multimodal treatment with chemotherapy and radiation may be the best treatment option.
While currently there is still no cure for mesothelioma, patients who receive multimodal treatment, particularly surgery plus chemotherapy, tend to survive longer than those who don’t. The Belgian mesothelioma clinical trial promises to help pleural mesothelioma patients survive even longer.
Young Investigator Award Supports Mesothelioma Clinical Trial
The Young Investigator Awards are presented at the biennial iMig conferences to promote the projects of up-and-coming young scientists and support a new generation of mesothelioma research.
Kazan Law, the sponsor of the Mesothelioma Circle blog, also sponsors the Young Investigator Awards. Kazan Law is proud to help studies like this mesothelioma clinical trial, which increase our knowledge and understanding about pleural mesothelioma.
Find a Mesothelioma Clinical Trial Near You
This Belgian study may not have trial sites in the US, but that doesn’t mean you can’t join a mesothelioma clinical trial. New clinical trials accept patients on a regular basis.
Some trials, like this one, will enroll mesothelioma patients who have just been diagnosed and haven’t yet received treatment. Others will enroll patients only after other mesothelioma treatments have stopped working. Many trials enroll patients at multiple medical facilities around the US or around the globe.
Mesothelioma patients have chosen to participate in scientific studies because they wanted to try new treatments and improve the outcomes for others affected by this deadly disease. The path of science is slow and any one study may not benefit a particular patient, but every mesothelioma clinical trial adds to the body of scientific knowledge that may someday lead researchers to a cure.