Navelbine and cisplatin/pemetrexed in treatment of pleural mesothelioma

A new study showed that adding chemotherapy to the treatment of sufferers of pleural mesothelioma had little effect in a large randomized trial. Neither of the two standard chemotherapy treatments - studied both together and alone - improved the length of life or increased the quality of life of the patients, according to Richard Stephens of the Medical Research Council Clinical Trials Unit.

However, a preliminary analysis showed that Navelbine, one of the chemotherapy treatments applied to the patients in the study, may have some benefits and should be studied more closely in the future. Unfortunately, the trial's results may have been muddled by factors outside of the researchers' control.

Alimta (the brand name for pemetrexed) combines with cisplatin is part of the standard treatment for mesothelioma.

As a result, the researchers tried to include the cisplatin and pemetrexed treatment in their study but were unsuccessful. Instead, they combined the two chemotherapy arms they were already using and maintained the three-arm randomization to analyze after the study.

Dr. Vogelzang, leader of the research group that completed the 2002 Almita study, said that the combination of cisplatin and pemetrexed is now standard treatment for mesothelioma. Dr. Vogelzang denied that there was any use for vinorelbine as a treatment for mesothelioma. He said: "I believe that single-agent chemotherapy offers little to patients in the way of palliation or survival, since [active symptom control] plus vinorelbine was statistically indistinguishable from [symptom control] alone."

In the current studies, the team discovered the following:

There is a small survival benefit from adding chemotherapy to active symptom control

Survival increased by .9 months on the median when chemotherapy was added to active symptom control

There was a non-significant improvement in survival rate when vinorelbine was used in addition to active symptom control

There was no benefit to adding cisplatin alone to active symptom control.

As far as quality of life, there was little difference in the groups, but adding cisplatin chemotherapy improved chest pain and sweating over active symptom control alone.

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