Triplet Chemotherapy Treatment New Standard for Malignant Pleural Mesothelioma
In September 2015, when results of the Mesothelioma Avastin Plus Pemetrexed-cisplatin Study (MAPS) trial were reported at the 2015 World Conference on Lung Cancer, the lead author of the study said, “The treatment of pemetrexed, cisplatin, and bevacizumab is a new treatment paradigm for patients with malignant pleural mesothelioma.” Now, this triplet combo is recommended by the National Comprehensive Cancer Network in its malignant mesothelioma cancer treatment guidelines – malignant pleural mesothelioma (MPM).
In the trial, cisplatin/pemetrexed chemotherapy treatment was augmented with bevacizumab (Avastin). The results showed the therapy resulted in “a significantly longer survival” for patients receiving bevacizumab with pemetrexed/cisplatin.
The recommendation from NCCN:
“The NCCN panel recommends cisplatin/pemetrexed (category 1) for patients with MPM. The NCCN panel also now recommends bevacizumab/cisplatin/pemetrexed as a first-line therapy option for patients with unresectable MPM who are candidates for bevacizumab.”
The NCCN guidelines are intended to help guide mesothelioma patients, their families, and the mesothelioma medical team, including physicians, nurses, and pharmacists, in the decision-making process in the management of cancer.
The NCCN is a not-for-profit alliance of 27 of the world’s leading cancer centers devoted to patient care, research, and education, dedicated to improving the quality, effectiveness, and efficiency of cancer care so that patients can live better lives, according to its website. Its guidelines are constantly reviewed and updated to keep up with the emerging medical breakthroughs.
Avastin was the first U.S. Food and Drug Administration-approved biological therapy designed to inhibit the formation of new blood vessels to tumors, slowing the growth and spread of the tumors. Studies have shown that VEGF, an autocrine growth factor released by mesothelioma cells, causes new blood vessels to form. VEGF levels are shown to be higher in mesothelioma patients.
Pleural mesothelioma is a cancer caused by past asbestos exposure found in the outer lining of the lungs called the mesothelium. Although there is no cure for mesothelioma, it can be treated with varying degrees of success through the use of surgical procedures, chemotherapy and radiation. Chemotherapy is administered to patients after surgery to prevent the disease from progressing, or as the primary treatment to shrink the tumor. The standard of care for pleural mesothelioma is the combination therapy of pemetrexed and cisplatin.
The recommendation can be found in the Journal of the National Comprehensive Cancer Network. The full guidelines can be found in “Malignant Pleural Mesothelioma Version 3.2016.”