June 14, 2020
Transarterial Chemoperfusion Studied for Treating Mesothelioma
June 14, 2020—The Society of Interventional Radiology (SIR) announced the presentation of research showing that transarterial chemoperfusion as a treatment for advanced mesothelioma is safe and effective and may improve the quality of life for patients who have few treatment options. The study was presented during a virtual session of the SIR’s 2020 annual scientific meeting held June 13-14.
Transarterial chemoperfusion treatment for malignant pleural mesothelioma (MPM) results in minimal side effects and shows promise for extending the lives of patients who have limited or no remaining treatment options, noted the SIR announcement.
Bela Kis, MD, an interventional radiologist at the Moffitt Cancer Center in Tampa, Florida, is the Principal Investigator on the study.
“MPM is a devastating cancer of the pleura, the membranes surrounding the lungs, that is very difficult to treat,” commented Dr. Kis in SIR’s press release. “The typical survival rate of patients with stage 3 and 4 MPM is around 12 months from diagnosis; but with this new treatment, we are hoping we might be able to extend patients’ lives beyond that—giving them more time with friends and family.”
As summarized by SIR, the phase 2 clinical trial enrolled 27 patients with MPM who underwent chemoperfusion treatment. All patients had received previous chemotherapy, and many received multiple lines of chemotherapy. Four of the patients had previous radiation therapy and three patients had pleurectomy. All continued to have disease progression before enrollment.
The interim results of the study showed a 70.3% disease control rate and a median overall survival rate of 8.5 months from the start of the chemoperfusion treatment. The treatment was well tolerated by patients, with a major complication rate of 1.4%. Most side effects were relatively minor, including mild nausea and chest pain.
“We were pleasantly surprised to find that this treatment doesn’t come with the same side effects of traditional intravenous chemotherapy,” stated Dr. Kis. “To see these promising results with so few side effects means we are able to make a positive impact on quality of life for these patients.”
Transarterial chemoperfusion delivers a relatively high concentration of drugs to diseased tissue in the lining of the lungs to maximize the treatment effect with limited side effects. In the treatment, interventional radiologists inject one-third of the chemotherapy cocktail of cisplatin, methotrexate, and gemcitabine directly into the internal mammary artery that supplies the pleura. The other two-thirds of the drugs are injected into the descending aorta, which reaches the intercostal vessels that also supply the pleura. The treatment is an outpatient procedure and typically requires 1 hour, followed by a 1-hour recovery.
SIR advised that the investigators are looking to expand their study to other cancer centers with larger MPM patient populations because the cancer is so rare. They also hope to add flexibility to the study to allow for increasing the dosage and changing the combination of medications for individual patients to determine whether either approach could further improve outcomes.
Currently, surgery is the only truly effective treatment for MPM, but the disease must be diagnosed early, only 10% to 20% of patients are candidates for surgery, and those patients often experience surgical complications, noted SIR.