Surgery is the best option to beat malignant mesothelioma. If it’s not available, what other treatment options are there?
This question is most pressing for older patients.
A new report shows the survival expectations for elderly mesothelioma patients receiving chemotherapy. Another report shows how immunotherapy helps the life expectancy for patients.
Many elderly people are unable to have surgery, so their only option is systemic therapy. Systemic therapy includes chemotherapy and immunotherapy.
Chemotherapy Not Enough for Patients
Chemotherapy is the oldest type of systemic treatment. The life expectancy for people with this cancer is around 14 months. The average is higher due to younger patients.
This new study included 262 cases of people age 66 or older. All of them received a combination of two chemotherapy drugs: cisplatin and pemetrexed. The median survival of these cases was 7.2 months. Epithelioid cases (12.2 months) outperformed biphasic and sarcomatoid cases (5.6 months).
Within 90 days of diagnosis and a short time after starting chemotherapy treatment, most of these patients were hospitalized. Around half went to emergency care. Only 86 cases had second-line chemotherapy, meaning the first line worked to an extent. Then 22 received three lines of chemotherapy.
The authors of the report explained the urgency for uncovering new therapies:
“Although first-line systemic anticancer treatment was generally consistent with guidelines (e.g., pemetrexed-platinum), poor patient outcomes highlight the need for effective treatment options for older patients,” they wrote.
Immunotherapy and Chemotherapy as a Team
Fortunately, immunotherapy is a new option for mesothelioma patients. It at least equals the life expectancy of chemotherapy. For non-epithelioid cases, the survival is much higher with immunotherapy than chemotherapy.
Only two immunotherapy drugs, Opdivo and Yervoy, are approved and widely used. More drugs, like durvalumab and ramucirumab, can provide other therapies.
Another study gave patients cisplatin, pemetrexed and nivolumab (Opdivo). The median survival was more than 20.8 months. Other improvements are:
- 94% disease-control rate
- 71% tumor-shrinkage rate
- 6-7 months usual response duration
- 8 months progression-free survival
- 100% 6-month survival rate
- 92% one-year survival rate
All of these data points are better than chemotherapy on its own against mesothelioma.
If you’re an older patient with mesothelioma, chemotherapy isn’t your only option. We could help enroll you in a clinical trial or explain how immunotherapy works. Please reach out to Karen Ritter, our patient advocate and registered nurse, at karen@mesotheliomaguide.com for her guidance.
Sources & Author
- Treatment patterns and outcomes in older patients with advanced malignant pleural mesothelioma: Analyses of Surveillance, Epidemiology, and End Results-Medicare data. Cancer Reports. Retrieved from: https://onlinelibrary.wiley.com/doi/10.1002/cnr2.1568. Accessed: 11/01/2021.
- JME-001 phase II trial of first-line combination chemotherapy with cisplatin, pemetrexed, and nivolumab for unresectable malignant pleural mesothelioma. Journal for Immunotherapy of Cancer. Retrieved from: https://jitc.bmj.com/content/9/10/e003288.long#DC3. Accessed: 11/01/2021.
Sources & Author
