A recent study presented the first case report of a malignant pleural mesothelioma patient effectively treated with a combination of nanoparticle albumin-bound paclitaxel (nab-paclitaxel) and carboplatin. The study, titled “Repetitive responses to nanoparticle albumin‐bound paclitaxel and carboplatin in malignant pleural mesothelioma,” was published in the journal Respirology Case Reports.
Malignant pleural mesothelioma (MPM) is a rare and very aggressive type of cancer with a median overall survival of 9.5 months, and highly associated with previous exposure to asbestos. Cisplatin in combination with pemetrexed is the primary chemotherapy treatment for patients with inoperable forms of the disease, but treatments options are limited for those unable to tolerate pemetrexed. Only a few agents have shown efficacy against MPM, the researchers reported in their study.
The research team reported that administration of carboplatin in combination with paclitaxel resulted in repetitive tumor regression in a 75-year-old man with a history of smoking and asbestos exposure, and diagnosed with stage 4 MPM. Nab‐paclitaxel, which is a particle form of paclitaxel of 130 nm in diameter, was developed to carry and deliver paclitaxel in a suspension of albumin protein particles in saline solution.
Carboplatin treatment has yielded higher response rates in patients with non-small cell lung cancer in comparison to paclitaxel treatment. However, nab-paclitaxel has several advantages over paclitaxel, such as a shorter infusion time and a standard infusion set. Nab-paclitaxel treatment also does not require the steroid or antihistamine premedication that is used to prevent hypersensitivity adverse reactions.
The team found “drastic decreases in interlobular nodules and pleural thickness” using carboplatin combined with nab-paclitaxel as a third-line therapy agent, and reported the man remained “progression free” for five months.
This case report suggested carboplatin as a potential alternative chemotherapy agent for malignant pleural mesothelioma, especially in patients who do not tolerate pemetrexed therapy. The authors, however, emphasized the importance of further studies exploring the treatment’s efficacy before it can become part of routine clinical applications.
Cisplatin, pemetrexed, and bevacizumab triplet therapy has been shown to result in significantly better MPM survival rates in comparison with cisplatin plus pemetrexed treatment.
Pemetrexed, gemcitabine, and vinorelbine are recommended secondary chemotherapy agents, according to the NCCN Clinical Practice Guidelines in Oncology.