Study Shows Switch-Maintenance Therapy May Extend Mesothelioma Survival

Study Shows Switch-Maintenance Therapy May Extend Mesothelioma Survival

Many mesothelioma patients undergo chemotherapy followed by supportive care. However, some studies show maintenance treatment after chemotherapy may be an effective combination.

Dutch researchers recently tested switch-maintenance treatment after first-line chemotherapy for mesothelioma. Results of the study show maintenance treatment with the chemotherapy drug gemcitabine may extend survival.

What Is Maintenance Therapy?

Maintenance therapy is a cancer treatment that typically occurs after a successful first round of treatment. The therapy often uses traditional chemotherapy drugs but may also include hormonal therapy or targeted therapy.

The purpose of maintenance therapy is to stop or delay cancer recurrence. It may also slow the growth of advanced cancers.

In the scientific community, maintenance therapy may be classified as continuation or switch.

  • Continuation maintenance therapy uses the same chemotherapy drug used in the initial treatment.
  • Switch-maintenance therapy uses a different mode of action from the first round of treatment. This means the initial treatment drug and the maintenance treatment drug work differently to kill cancer cells.

Maintenance therapy may be more effective for certain cancers than it is for others. In a recent clinical trial, researchers studied the efficacy and safety of switch-maintenance therapy on mesothelioma patients.

Researchers Test Switch-Maintenance Therapy on Mesothelioma Patients

Researchers at the Netherlands Cancer Institute recently tested switch-maintenance therapy on mesothelioma patients. Researchers specifically tested maintenance therapy using the chemotherapy drug gemcitabine.

The study included 130 pleural mesothelioma patients. All patients in the study had:

  • Unresectable mesothelioma, meaning their tumors could not be surgically removed
  • Received at least four cycles of first-line chemotherapy using a platinum-based drug and pemetrexed
  • No evidence of mesothelioma progression

Researchers randomly divided the patients into two groups. The first group received maintenance therapy using gemcitabine and supportive care. The second group only received supportive care.

Patients in the first group received gemcitabine intravenously on days one and eight in 21-day cycles. This maintenance treatment continued until:

  • A patient developed a serious-simultaneous illness
  • A patient’s cancer progressed
  • A patient needed additional cancer treatment, except radiotherapy

Study participants could also choose to stop maintenance treatment.

Gemcitabine Delayed Cancer Progression for Some Patients

The group of patients treated with gemcitabine had longer progression-free survival. This means the gemcitabine group experienced a longer period without cancer progression than the supportive care group.

Median Progression-Free Survival

Group treated with gemcitabine: 6.2 months

Group treated with supportive care: 3.2 months

Average median survival was also longer for patients in the gemcitabine group. However, the difference in overall median survival between the two groups was not statistically significant.

Overall Median Survival

Group treated with gemcitabine: 16.4 months

Group treated with supportive care: 13.4 months

Overall, researchers found switch-maintenance therapy with gemcitabine significantly prolonged progression-free survival for pleural mesothelioma patients.

Patients Treated With Gemcitabine Experienced More Adverse Events

Researchers in the study also tracked the number of adverse events experienced by patients. Adverse events are undesirable medical problems graded on a 1 – 5 scale. Higher numbers are associated with more serious issues.

  • 52% of patients in the gemcitabine group experienced a grade 3 – 4 event
  • 16% of patients in the supportive care group experienced a grade 3 – 4 event

Additionally, one patient in the gemcitabine group died due to a treatment-related infection.

Patients in the gemcitabine group were also more likely to experience certain side effects, including:

  • Anemia
  • Asthenia
  • Fatigue
  • Neutropenia

Both groups experienced side effects of pain and infection.

Patients should discuss potential side effects with their doctors before beginning any mesothelioma treatments. For some patients, benefits may outweigh potential risks.

Is Maintenance Therapy With Gemcitabine Effective for Mesothelioma Patients?

Results of the study show switch-maintenance therapy with gemcitabine may extend progression-free survival for some mesothelioma patients. Improved progression-free survival may also positively impact patient quality of life.

However, a high percentage of patients treated with gemcitabine experienced adverse medical events.

Future research may further test the efficacy of maintenance therapy after chemotherapy treatment. Patients interested in this form of treatment should contact a mesothelioma doctor about upcoming clinical trials.