New Study Says Bidirectional Chemotherapy 'Promising' Preoperative Method for Malignant Peritoneal Mesothelioma
A new study says bidirectional chemotherapy is a promising preoperative method for malignant peritoneal mesothelioma (MPM). A team of researchers evaluated 20 consecutive patients treated for diffuse MPM not suitable for upfront surgery, who received bidirectional chemotherapy associating intraperitoneal and systemic chemotherapy between January 2013 and January 2016. Evaluation of the response to chemotherapy was assessed clinically and by laparoscopy. The results are as follows:
“The median peritoneal cancer index (PCI) score at staging laparoscopy was 27 (range 15–39). Altogether, 118 intraperitoneal chemotherapy cycles were administered without any specific adverse catheter-related event. Concerning tolerance, 85% of the patients experienced no pain or mild pain during chemotherapy administration. The clinical response rate was 60% after a median of three chemotherapy cycles. At laparoscopic reevaluation, the median PCI was 18 (range 0–35), and a secondary resectability was considered for 55% of the patients. Complete cytoreduction surgery followed by hyperthermic intraperitoneal chemotherapy (HIPEC) was finally achieved for 10 patients (50%), with a median intraoperative PCI score of 14 (range 6–30). After a median follow-up period of 18 months, the 2-year overall survival rate was 83.3% for the patients treated by CRS followed by HIPEC and 44% for the patients treated by bidirectional chemotherapy.”
The researchers concluded that, “bidirectional chemotherapy is a promising, well-tolerated treatment capable of increasing the resection rate for selected patients with diffuse MPM initially considered as unresectable or borderline resectable. For patients with definitively unresectable disease, bidirectional chemotherapy achieves a higher clinical response rate.”
Peritoneal mesothelioma is an aggressive cancer caused by ingesting asbestos fibers. The disease accounts for around 20-33 percent of mesothelioma cases diagnosed each year, making it the second most common type of mesothelioma. Though MPM could strike any population, the disease is found primarily in the 50- to 69-year age group. Further, it is more common in men, possibly because of the higher male occupational exposure to asbestos.
The incidence of occupational and environmental asbestos exposure still remains a public health problem around the world, with a significant increase in the past two decades. If you have been exposed to asbestos, please see your doctor immediately. Although there is no cure for mesothelioma, treatment advances have made it possible to extend the length and quality of life in patients.
Bridda, Alessio, Ilaria Padoan, and Roberto Mencarelli. "Peritoneal Mesothelioma: A Review." Medscape General Medicine. Medscape, 2007. Web. 14 Jan. 2018.
"Cytoreductive Therapy." CancerCenter.com. Cancer Treatment Centers of America (CTCA), Jan. 2017. Web. 14 Jan. 2018.
Roy, Florence Le, Maximiliano Gelli, and Antoine Hollebecque. "Conversion to Complete Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy for Malignant Peritoneal Mesothelioma After Bidirectional Chemotherapy." SpringerLink. Springer International Publishing, 28 Aug. 2017. Web. 14 Jan. 2018.