Treatment options for malignant mesothelioma

Chemotherapy

With chemotherapy, drugs are given by injection or by mouth, to kill tumor cells or stop their growth. Chemotherapy with a wide range of substances has had limited success in malignant mesothelioma. In general, any single drug has produced responses in only up to 20% of patients; average rates are only 9-12%. Many combinations of chemotherapeutic agents have been tried in malignant mesothelioma, but have not improved survival rates much.

Drugs that have been used for malignant mesothelioma include:

• doxorubicin (the most widely studied)
• cisplatin & carboplatin.
• vincristine & vinblastine.
• ifosfamide, mesna & cylcophosphamide.
• methotrexate (which has had better response rates than other agents).

These drugs are generally quite toxic, and produce a number of side effects. There appears to be evidence that chemotherapy with such agents may improve survival rates when used in conjunction with surgery.

New drugs are being investigated for the management of malignant mesothelioma. In 2004, patients are being recruited in a study assessing the benefits of adding the new agent Onconase to doxorubicin after encouraging results in early trials. In early 2004 a new chemotherapy agent, Alimta, was approved for the treatment of malignant mesothelioma.