Out of all the types of mesothelioma, pericardial mesothelioma is one of the rarest forms, accounting for only 0.002% of all known diagnosed mesothelioma cases. Mesothelioma is caused by asbestos exposure, and despite this knowledge and years of research, scientists and researchers still do not have a clear answer as to how the asbestos fibers make their way into the pericardial cavity. Diagnosing this fatal cancer can also be difficult – the cancer appears in the later stages of the disease and symptoms frequently mimic other heart conditions.
Surgery is the treatment of choice for pericardial mesothelioma, but unfortunately in many cases, it is inoperable. It is because of this that scientists and researchers are attempting to find a standard chemotherapeutic regimen that uses cisplatin and pemetrexed – two first- line chemotherapy treatments for pleural and peritoneal mesothelioma. A 2016 study published in Oncology Letters reported a positive response after a pericardial mesothelioma patient was treated with a combination therapy of pemetrexed and cisplatin, followed by pemetrexed maintenance chemotherapy.
The Oncology Letters reported of a 53-year old women suffering from pericardial mesothelioma whose work history included working in a small factory making electrical units. At CT of the chest showed pericardial thickening and masses surrounding the heart and the patient’s cancer appeared to metastatic, as tiny nodules were found in lung as well as the chest. Cisplatin and pemetrexed was administered as a palliative chemotherapy, or chemotherapy that is meant to treat the symptoms and manage pain, in a three-week cycle; pemetrexed being the higher dosage. By just the second round of treatment, the pericardial thickening began to shrink and did so continuously throughout the therapy. Cisplatin dosage was eventually lowered and phased out completely by the fourteenth cycle; only pemetrexed was infused every three weeks.
The study concluded that the pemetrexed maintenance following the combination therapy of cisplatin and pemetrexed is one of the most ideal options for chemotherapy in pericardial mesothelioma patients who are not able to have surgery.
A more recent case report published in the Journal of Korean Medical Science noted similar results just a little over a year later. This time, the case presented itself with a 71-year-old women who was suffering from pericardial mesothelioma. She also received a combination treatment of pemetrexed and cisplatin over the course of a 6-month cycle. For a cancer that has an average survival rate of less than one year, this patient survived two years, without disease progression.
Even though there is still no cure for mesothelioma, positive results from studies like these give scientists and researchers hope that the cure it out there, they just need to find the right combination. Stopping disease and tumor progression and prolonging survival are some of the characteristics that scientists see that show they are headed in the right direction to finding the most effective treatment possible.
Sources:
Kim JS, et. al. “A Case Report of Primary Pericardial Malignant Mesothelioma Treated with Pemetrexed and Cisplatin,” Journal of Korean Medical Science (2017 November). [Link]
Sang Mi Chung, et. al. Positive Response Of A Primary Malignant Pericardial Mesothelioma To Pemetrexed Plus Cisplatin Followed By Pemetrexed Maintenance Chemotherapy: A Case Report,” Oncology Letters (July 2016). [Link]
