A recent multicenter retrospective study conducted in France suggests that response rate to chemotherapy treatment in patients with malignant pleural mesothelioma (MPM) is low when compared to results from clinical trials. The study, entitled “Management of malignant pleural mesothelioma: a French multicenter retrospective study (GFPC 0802 study),” was published in the BMC Cancer journal.
MPM is a rare form of cancer that affects the protective lining of internal organs of especially the lung and internal chest wall. The disease is mainly associated with asbestos exposure, where the risks are proportional to the degree of exposure and its incidence varies among countries and population subgroups.
From a therapeutic viewpoint, treatment of MPM is primarily based on a chemotherapy regimen that has been proven to improve survival in randomized and controlled trials. However, routine practice may provide different results from that observed in controlled clinical trials.
This study aimed to perform a multicenter retrospective study in France by describing patients’s profiles and the treatment of MPM in France. To proceed, data from medical files of patients with histologically proven MPM diagnosed from January 2005 to December 2008 were collected and analyzed.
A total of 406 MPM patients, predominantly males with a mean age of 68.9 years and latency of the disease of 45.7 years, participated in 37 different sites for the study. Among the participants, 83% had vascular cancer in the lining of blood vessels (epithelioid). The patients were mainly diagnosed by means of thoracoscopy (80.8%), a medical procedure performed under general anesthesia or sedation that involves internal examination, biopsy, and/or resection of disease within the lung’s cavities. Radical surgery was performed in 6.2% of cases, and 74.6% of patients received first-line chemotherapy treatment consisting of a combination of drugs (platinum, pemetrexed 91% or pemetrexed alone 7%). The patients who did not respond well to first-line chemotherapy were treated by second-line chemotherapy consisting of (platinum + pemetrexed 31.6%, pemetrexed alone 24.6%), then followed by third-line chemotherapy if the second-line chemotherapy did not work.
The results suggested that 17.2% of patients had complete or partial response to first-line chemotherapy treatment, and another 41.6% of patients experienced disease stabilization. Half of the patients did not respond well to first-line therapy, and endured second-line chemotherapy that yielded a 6% response rate. For patients who underwent third-line chemotherapy (56 patients), the treatment resulted in disease control in 5.4% of cases.
Overall, this study concluded that management of MPM in France is in accordance with European recommendations and guidelines. When compared to results described in clinical trials, the response rate from this study remains low. As a result, new treatment options are urgently required to improve the prognosis of patients with MPM.