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Does Chemotherapy Cure Peritoneal Mesothelioma?

Why Doesn’t Chemotherapy Treatment Cure Peritoneal Mesothelioma?

For reasons that aren't entirely understood yet, chemotherapy in the treatment of peritoneal mesothelioma works differently for nearly every patient. In some cases the difference can be dramatic. Certain drugs can make a major impact on one person’s tumor but have absolutely no effect on the next. To date, the biggest obstacle to treating peritoneal mesothelioma with chemotherapy alone is either that the amount of tumor present is too large for the chemo to destroy it or that the tumor develops resistance to the chemo. Surgery can assist with the first problem by reducing the tumor remaining to a manageable amount that chemo can handle.

It is the second problem that is so intriguing and holds so much promise. It appears that not every tumor cell uses the same pathways to grow and to spread. Attacking some but not all of the pathways used by the tumor to replicate will reduce only a portion of the tumor burden, allowing the tumor that is left to grow unimpeded. This is the primary reason single chemotherapy protocols don't cure the tumor and seem to stop working after a number of months. Using multimodality chemotherapy treatments for peritoneal mesothelioma seems to be much more effective since it attacks multiple pathways at once, allowing the tumor no room to evade treatment. Once all the pathways have been identified and drugs found that will interfere with them, it may be possible to use chemo alone as a curative treatment.

Advancements in Chemotherapy Treatment

Our current knowledge of the development of cancer has established that each tumor is a reflection of the different genetic makeup of the host individual’s cells. Recently, attempts have been made to grow test tube cultures of a person’s tumor and then expose them to a variety of chemical solutions in vitro (in a test tube solution). The problem appears to be that success in the test tube doesnt always translate into an effective tumor fighting treatment when it is tried in vivo or in a live subject. A vigorous debate is underway as to whether this approach has merit or not.

Chemotherapy protocols have changed and continue to change quickly. Multimodality mesothelioma treatment employing surgery, with Gemcitabine (Gemzar) Cisplatinum, Carboplatinum and other chemotherapies are now being adapted to use monoclonal antibodies like Iressa and Tarceva as well as anti-angiogenesis drugs like bevacizumab and endostatin as well as new targeted drugs like deacetylase inhibitor SAHA, to attack the tumor from multiple directions at once. Drugs like Interferon, Thalidomide and Cox2 inhibitors like Celebrex are being tried in various combinations to boost the effectiveness of chemotherapies.

The arrival of Alimta, the first drug that showed a significant response in mesothelioma as a single agent is now being tested in clinical trials looking at combination therapies.

Chemotherapy protocols have changed and continue to change quickly. Please Contact the Mesothelioma Research Foundation for more information on new and evolving chemotherapy and mesothelioma treatment investigations