Response of Mesothelioma Patients’ Tumors to Chemotherapy May Offer Clues

Researchers at Columbia University report that changes in the size of tumors in patients with pleural mesothelioma who have undergone chemotherapy may be useful in predicting their response to mesothelioma treatment and survival. Pleural Mesothelioma is an incurable cancer of the lining of the lung associated with exposure to asbestos.

Thousands of Americans have been exposed to asbestos in building materials and manufacturing, and 2,000 to 3,000 die each year of mesothelioma. Typically, 30 to 40 years elapse between the asbestos exposure and the onset of cancer symptoms. Doctors often don’t diagnose the disease until it has reached an advanced stage. The median survival is a year to 18 months.

In a new article in the Journal of Thoracic Oncology, researchers at Columbia’s Memorial Sloan-Kettering Cancer Center describe the outcomes of clinical trials involving 30 mesothelioma patients who were treated with chemotherapy followed by surgery and radiation.

The researchers took CT scans of the 30 patients’ lungs and calculated the size of their tumors before and after two rounds of chemotherapy treatment. Patients diagnosed with stage III and stage IV cancer generally had larger tumors than those with less advanced cancer. The percentage change in the size of the tumor from the initial measurement to their evaluation after two cycles of chemotherapy was strongly associated with patients’ overall survival, the researchers said. They found a significant difference in the length of survival among patients whose tumors increased after chemotherapy and those whose tumors decreased.

The researchers said computer-aided measurements of tumors may offer doctors a more reliable way to assess patients’ response to treatment and could provide additional information about patients’ prognosis.