Tailored Treatment Options May Lead to Improved Outcomes in Mesothelioma Patients

Tailored Treatment Options May Lead to Improved Outcomes in Mesothelioma Patients

New research suggests that personalized treatment options based on a patient’s unique genetic biomarkers could lead to improved outcomes in cancer patients, including those suffering from mesothelioma.

The study, “Clinical-pharmacogenetic models for personalized cancer treatment: application to malignant mesothelioma,” was published in the online journal Scientific Reports.

There is a high degree of variability in outcomes among cancer patients undergoing chemotherapy. Personalized medicine is a field of study that focuses on utilizing an individual patient’s unique genetic makeup to better tailor treatment options to a particular patient.

Previous research has suggested that individual variability in genes coding for drug metabolism and transport, as well as proteins involved in DNA repair, all play a role in an individual patient’s response to chemotherapy and could potentially be used to individualize treatment options.

Malignant mesothelioma (MM) is an aggressive form of cancer typically linked to asbestos exposure. MM forms on the thin lining that protects the lungs and abdomen. Despite the introduction of chemotherapy, response rates are only up to 40 percent and long-term survival remains poor.

To determine if individual genetic biomarkers could be used to guide targeted treatment in patients suffering from mesothelioma, 189 patients were genotyped for variations in genes responsible for the metabolism and transport of chemotherapy drugs, as well as for drug target genes and DNA repair pathways.

Scores were then calculated based on two different treatment options — Gemzar (gemcitabine)/Platinol (cisplatin) and Alimta (pemetrexed)/Platinol. Researchers then proposed a treatment option based on several variables including laboratory serum values and genetic subtypes. Interestingly, the proposed treatment algorithm enabled the selection of the most effective chemotherapy drug in 85.5 percent of patients.

Researchers hope that refined treatment options based on an individual’s unique genetic makeup will lead to improved outcomes and fewer side effects.

“In conclusion, we have developed clinical-pharmacogenetic models for predicting gemcitabine/cisplatin and pemetrexed/cisplatin treatment outcome. Using the proposed algorithm, effective chemotherapy could be recommended for 85.5% of MM patients; however, this needs to be confirmed in a prospective study,” the researchers wrote.

“A similar approach could be used for selecting the most favorable treatment option and thus improving outcomes of chemotherapy in other cancers where more treatment options are available,” they added.

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James Frederick is a practicing Physician Associate (PA-C, MMSc) who studied at Yale University. He also has a bachelor’s degree in creative writing and English Literature from the University of Colorado. He specializes in writing medical content that is approachable, readable and enjoyable. He has a strong background in research, physiology, pharmacotherapy, emergency medicine and critical care medicine. In his free time, he enjoys spending time camping and traveling with his wife and dog.

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