Immediately after a patient’s mesothelioma is diagnosed, physicians work to come up with the most effective treatment approach. Many patients are treated using a multi-modality protocol that includes a combination of chemotherapy, radiation therapy and surgery, though the order of delivery is highly dependent upon the patient’s specific condition. It is not unusual for surgeons to suggest a round of neoadjuvant chemotherapy, which is delivered prior to surgery in order to shrink the tumor. But a study of that practice out of Duke University has reported that post-surgical survival for patients who have their surgery sooner is better. Researchers are notably surprised by these results, which are likely to have a significant impact on future treatment decisions.
Study Shows Mesothelioma Survival Improved by Skipping Pre-Surgical Chemo
Administering chemotherapy prior to surgery is common for many cancers, but in mesothelioma it is not part of the standard of care. The Duke University researchers set out to determine whether the protocol provided improved outcomes for patients, but were surprised at the stark difference that they found.
In an article published in the Journal of the National Cancer Institute, they reported that based on results from 250 patients as well as records from 2,000 patient outcomes recorded in the National Cancer Database, neoadjuvant chemotherapy was associated with worse survival outcomes after surgery than the outcomes of patients whose surgeries were scheduled immediately, without waiting for a course of chemotherapy to be completed.
Mesothelioma Study Concludes That Going Straight to Surgery is Better
Though the mesothelioma researchers were aware that administering several cycles of chemotherapy takes approximately three months, thus delaying surgery by that amount of time, they had anticipated that the elapsed time would be worthwhile for patient outcomes. Notably, adjuvant chemotherapy sometimes stops cancer in its tracks, or even brings about remission in some types of cancers. But the study’s results were clear.
Moving forward, it is advisable for surgeons to closely review the study’s results and keep them in mind when making decisions and recommendations for their patients with malignant mesothelioma. Some oncologists theorize that the reason why neoadjuvant chemotherapy delivers different results in mesothelioma than in other cancers is because the therapy is not that effective for mesothelioma to begin with, and only provides a positive response in about 20% of patients.
If you or someone you love has malignant mesothelioma, staying up-to-date on research is essential. For information on the care and resources available to you, contact the Patient Advocates at Mesothelioma.net at 1-800-692-8608.
