According to the results of a phase III clinical trial published in the Journal of Clinical Oncology, treatment with both cisplatin and raltitrexed results in better survival among patients with malignant pleural mesothelioma than treatment with cisplatin alone.
Malignant pleural mesothelioma is a rare cancer that develops in the tissue that covers the lungs and lines the interior of the chest. The majority of individuals who develop malignant pleural mesothelioma have a history of chronic exposure to asbestos. Patients with advanced mesothelioma are often treated with chemotherapy in order to improve quality of life or duration of survival. Researchers continue to evaluate new combinations of chemotherapy drugs in order to improve treatment responses.
In order to evaluate whether treatment with the combination of the drugs cisplatin and raltitrexed results in better survival than treatment with cisplatin alone, researchers in Europe and Canada conducted a phase III clinical trial among 250 patients with malignant pleural mesothelioma. Patients were randomly assigned to be treated with cisplatin alone or cisplatin plus raltitrexed.
The study produced the following results:
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- Patients treated with the combination of cisplatin and raltitrexed were more likely to experience a reduction in their cancer than patients treated with cisplatin alone.
- Twenty-four percent of patients treated with the combination of drugs experienced an anti-cancer response to treatment, compared to 14% of patients treated with cisplatin alone.
- Survival was longer among patients treated with the drug combination.
- Forty-six percent of patients treated with cisplatin and raltitrexed survived for at least one year, compared to 40% of patients treated with cisplatin alone.
Adverse effects of treatment were more common among patients treated with the combination of drugs and included low white blood cell levels and vomiting. Nevertheless, there was no difference in health-related quality of life between the study groups.
The researchers conclude that the treatment of malignant pleural mesothelioma with the combination of cisplatin and an antifolate drug such as raltitrexed is superior to treatment with cisplatin alone.
Patients with malignant pleural mesothelioma may wish to talk with their doctor about the risks and benefits of participating in a clinical trial further evaluating these or other therapeutic approaches. Sources of information regarding ongoing clinical trials include the National Cancer Institute (www.cancer.gov).
Reference: van Meerbeeck JP, Gaafar R, Manegold C ete al. Randomized phase III study of cisplatin with or without raltitrexed in patients with malignant pleural mesothelioma: an intergroup study of the European Organisation for Research and Treatment of Cancer Lung Cancer Group and the National Cancer Institute of Canada. Journal of Clinical Oncology. 2005;23:6881-6889.