Researchers Cautiously Optimistic About “Triplet” Therapy for Malignant Mesothelioma
Researchers from the MD Anderson Cancer Center in Houston demonstrated cautious optimism about their recent study of a triple neoadjuvant regimen using cisplatin, pemetrexed, and atezolizumab. Speaking at the virtual World Congress on Lung Cancer, the scientists reported that sixty percent of eligible patients who received the triplet therapy moved on to surgical resection or maintenance treatment with no treatment-related adverse effects.
Small Study Involved 25 Mesothelioma Patients
According to Boris Sepesi, MD, the phase 1 study began 20 months ago and included 25 patients diagnosed with stage I-III malignant pleural mesothelioma. At this point in the follow-up, median overall survival has not yet been reached, marking a significant improvement over other protocols. But Sepesi urged restraint in interpreting the group’s data, saying it “was a feasibility trial, so we cannot overstate the results. Until the final analysis is done, I would like to refrain from speculating on the benefit of adding atezolizumab to the regimen.”
Median progression-free survival for the mesothelioma patients in the study was marked at 18.6 months. Conference moderator Anne-Marie Baird, PhD of Trinity College in Dublin also pointed to the small study size and reminded attendees that the study only included patients deemed eligible for surgical resection, which is not typical for the rare, asbestos-related disease. The study was also limited to patients with no previous mesothelioma treatment history.
Mesothelioma Patients Received At Least Two Cycles of Triplet Treatment
In detailing the protocol, Sepesi said that 25 patients received at least two cycles of the triplet protocol. Following treatment 18 underwent surgical resection of their tumors and 15 received maintenance treatment with atezolizumab. Three are continuing to receive treatment. There was one treatment-related death from sepsis related to non-immune related renal and respiratory failure.
Since previous surgical trials of mesothelioma treatment have not generally included neoadjuvant therapy, the researchers’ next step will be to divide patients into nodal status. Historically, overall survival ranges between 17 and 25 months are expected in surgically managed mesothelioma.
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