Mesothelioma is a notoriously difficult disease to treat, and the fact that it appears in different areas of the body makes diagnosis and clinical approaches even more challenging. A recent study published by researchers at Harbin Medical University in Harbin, China, provides case reports demonstrating dramatically different treatment outcomes in two patients with this rare and aggressive cancer.
Mesothelioma Patients Experience Dramatically Different Outcomes
Mesothelioma can appear in the pleural or peritoneal cavities, as well as the pericardium and the tunica vaginalis. Pleural mesothelioma accounts for 81 percent of cases and carries an extremely poor prognosis, with a median overall survival of only one year, while patients diagnosed with peritoneal mesothelioma can experience longer survival times. The researchers report on a 72-year-old woman with peritoneal mesothelioma who had a remarkable response, compared to the much less positive results experienced by a 59-year-old male with pleural mesothelioma.
The peritoneal mesothelioma patient’s chemotherapy treatment resulted in her lesion shrinking from 150×160mm to being radiologically undetectable after treatment. Unfortunately, the pleural mesothelioma patient first experienced resistance to platinum-based chemotherapy. His disease progressed after first-line pemetrexed/cisplatin and subsequent second-line chemotherapy.
Mesothelioma Diagnosis Requires a Combination of Imaging and Pathology
Mesothelioma affects approximately two out of every 100,000 people. The deadly asbestos-related disease presents significant diagnostic and therapeutic challenges involving a complex, multi-stage process. Diagnosis relies on a combination of imaging and histopathological examination, with immunohistochemistry playing a pivotal role in distinguishing it from metastatic adenocarcinoma. Patients with pleural mesothelioma generally present with symptoms including pleural effusion, chest pain, and dyspnea, while peritoneal mesothelioma typically manifests with abdominal distension, pain, and ascites.
Despite advances in treatment, the prognosis for mesothelioma remains poor. Platinum-based chemotherapy has been the standard first-line treatment for decades, but the treatment landscape has significantly shifted with the discovery of immune checkpoint inhibitors. The use of these has shown benefit for selected patients, though response has varied, and its impact when used on different anatomical sites is not fully understood. The contrasting outcomes between the two reported cases—one showing dramatic tumor shrinkage and the other exhibiting treatment resistance—underscore that challenge, making precise pathology and individualized treatment based on anatomic site and genetic markers crucial.
If you or someone you love has been diagnosed with mesothelioma, research holds the key to a better future. For more information on resources available to you, contact the Patient Advocates at Mesothelioma.net today at 1-800-692-8608 to learn more.
