Vinorelbine could be a useful second-line treatment for patients with relapsed mesothelioma. A phase II clinical trial examined vinorelbine to see how effective it is in patients who had their pleural mesothelioma progress after platinum chemotherapy treatment. Doctors believe vinorelbine could be another option for patients instead of the standard platinum-based chemotherapy. The study, which had 154 patients with relapsed disease, proved to some doctors that vinorelbine is ready to be used as a regular treatment.
There are no approved second line treatments for pleural mesothelioma. Second line treatments can depend on the cancer center administering it, and the treatment is usually palliative, which means it is not fighting the disease, it is just making the patient more comfortable. Vinorelbine is a type of chemotherapy called an antineoplastic agent. It has low toxicity and can be used with multiple cancers, usually in people after their cancer reoccurs. It is approved for non-small cell lung cancer in the United States and has also been used internationally, but doctors debate if it is worthwhile treating mesothelioma with it after a relapse. There is no conclusive proof that Vinorelbine is a good first line treatment, so researchers chose to study and see if it could be used as a primary treatment for mesothelioma.
The study’s findings were presented at the annual meeting of the American Society of Clinical Oncology. The median progression free survival for patients receiving vinorelbine was 4.32 months compared to 2.8 months for patients only receiving symptom control. The stable disease rate was also larger at 62.2 percent compared to 46.6 percent for patients not in the vinorelbine group. The median length of response was also longer at 7.2 months for the vinorelbine group versus 4.2 months for the other group. The patients receiving treatment took it orally for 21 days, which then escalated for the next two months. Patients had less side effects compared to other types of chemotherapy with 12.5 percent having neutropenia, 6.2 percent having difficulty breathing, and 5.2 percent having lower respiratory infection.
There are not enough second line treatments for mesothelioma. Keytruda (pembrolizumab) has been approved, but only for certain patients. It works well for some patients but for others it is not effective at all. There is no cure for mesothelioma, but certain treatments including surgery and chemotherapy can help extend the lives of patients. Many patients do not qualify for surgery though because their disease has spread so much that they are not well enough to undergo the procedure. Also, when patients receive just chemotherapy, their cancer ends up relapsing. Data from this study proves that vinorelbine can delay the progression of mesothelioma by 40 percent. Researchers suggest that vinorelbine should be considered as a second line treatment for mesothelioma after their cancer relapses.
