In the world, this cancer has increased. For example, in England, the death rate increased by a factor of 12 between 1968 and 2001, and nearly 2000 deaths recorded in 2005. In 2013, the annual death rate due to mesothelioma is expected to increase to 2200. Found similar mortality rates in the United States and in Western Europe. Because the risk of exposure to asbestos, however, the epidemic will shift towards countries that produce or use large quantities of asbestos, such as Russia, China, Canada, Kazakhstan, Brazil, Zimbabew, India, and Thailand.
For mesothelioma patients, the addition of chemotherapy to control symptoms of the common active (ASC) does not appear to improve survival or quality of life, according to an article released on May 16, 2008 in The Lancet. Malignant pleural mesothelioma (MPM) is a cancer of the mesothelium, a protective layer that covers the lungs. Commonly associated with asbestos exposure, it is almost always fatal.
To investigate the various treatment options for patients with MPM, Richard Stephens and Professor Mahesh Parmar, Medical Research Council (MRC) Clinical Trials Unit, London, England, and colleagues conducted a study of MS01, which is funded by Cancer Research UK. This randomized trial examined 409 patients with MPM from 76 centers in England and two in Australia. OF these, 136 were randomly assigned to ASC alone; 137 ASC plus MVP chemotherapy was given, which involves four cycles of mitomycin, vinblastine, and cisplatin every three weeks, while the remaining 136 patients received ASC plus vinorelbine chemotherapy, a single injection of vinorelbine every week for two twelve weeks. Follow up is done every three weeks to 21 weeks after treatment. Due to the limited number of subjects recruited, assessment of individual chemotherapy treatment is not possible, so that the groups were combined and compared with the basic ASC only group for the primary outcome of overall survival.
When the analysis is done, 393 (96%) of patients had died. 132 comes from the ASC alone group, 132 came from the ASC / MVP, and 129 comes from the ASC / vinorelbine group. Small advantage for combination therapy is present but not statistically significant. Patients in the ASC / vinorelbine also showed increased survival, with a larger number alive after one year, but this is also not statistically significant. Analysis of quality of life in each group, including physical function, pain, shortness of breath, and overall health status, were similar.
The authors conclude that certain therapeutic methods do not improve the lot of patients with mesothelioma: "The addition of chemotherapy to ASC offers no significant benefits in terms of overall survival or quality of life, however, exploratory analysis suggests that further investigation of vinorelbine benefits .. "
Dr. Nicholas J Vogelzang, Nevada Cancer Institute, Las Vegas, NV, United States, contributed an accompanying comment in which he discusses the evidence on various regimens of chemotherapy for this disease. "Patients with MPM who want to be treated should be informed that the medical evidence which strongly sets the standard of care for MPM as cisplatin and pretrexed. Although cisplatin plus gemcitabine may be equally effective, there has never been a randomized comparison of two doublet regimens. "
