A study published in the latest edition of The Lancet has compared two of the different forms of chemotherapy which are available to those who have been diagnosed with malignant pleural mesothelioma. 

Mesothelioma is a tumour of the lining of the lung usually caused by a person’s exposure to asbestos during the course of their employment often decades before they are diagnosed. 

The MS01 study was funded by Cancer Research UK to investigate different treatment options for those suffering from mesothelioma. It was pioneered by Richard Stephens and Professor Mahesh Parmar both of the Medical Research Council (MRC) Clinical Trials Unit in London together with other doctors throughout the UK. 
The study compared patients who underwent one of two different chemotherapy regimes with those who did not have any form of chemotherapy, instead they simply received medication to control and relieve their symptoms (active symptom management).  Those who underwent chemotherapy also received any necessary medication to control their symptoms.   

Medication which is given to help control symptoms includes, steroids, painkillers including opiates, bronchodilators and palliative radiotherapy. 

The patients involved in the study who had chemotherapy either had combination therapy (four cycles of mitomycin, vinblastine, and cisplatin every three weeks) or vinorelbine chemotherapy (one injection every week for twelve weeks).   

In total 409 patients were involved in the study.  The patients were treated at 76 centres around the UK and also at 2 centres in Australia. 

Of the group of 409 patients, 136 patients received active symptom management, 132 underwent the combination therapy and 136 had vinorelbine chemotherapy. 
At the time the study concluded, 393 or 96% of the 409 patients had died. 

Results

The study’s main finding was that those patients who received either form of chemotherapy were no better off than those who simply had active symptom control.
Due to an insufficient number of patients, an assessment of the individual chemotherapy treatments was not possible when considering overall survival.  The two groups were therefore combined together.  The results showed that when comparing the two chemotherapy groups together with those only receiving symptom treatment, there was only a slight improvement in survival rates after one year.   

A person’s quality of life was also considered.  The factors considered were the patient’s physical ability to function, their pain, their shortness of breath and their overall health status. The study found that the overall results were similar in all three groups with no one group having any better quality of life than the other. 

The authors concluded “The addition of chemotherapy to active symptom control offers no significant benefits in terms of overall survival or quality of life. However, exploratory analyses suggested that vinorelbine merits further investigation,"

There are further types of chemotherapy which are available for the treatment of malignant pleural mesothelioma. NICE has recently said that alimta (pretrexed) a different form of chemotherapy is to be available to patients on the NHS. 

As Dr Nicholas J Vogelzang of the Nevada Cancer Institute, says “Patients with malignant pleural mesothelioma who wish to be treated should be informed that strong medical evidence establishes the standard of care for malignant pleural mesothelioma is cisplatin and pretrexed(alimta). Although cisplatin plus gemcitabine might be equally effective.” Click here for link to comment.

Background

Mesothelioma is an asbestos-related cancer that affects the lining around the lungs (the pleura) and certain other organs such as the peritoneum. There is no cure for mesothelioma. Radical surgery is available to a limited number of eligible patients. The condition can be difficult to diagnose and patients generally survive less than 18 months from diagnosis. The only known cause of mesothelioma is asbestos. Mesothelioma often occurs 30 to 40 years after asbestos exposure, with no upper time limit. Although mesothelioma is an occupational disease, victims include teachers, nurses, doctors, shop workers and family members of people who have worked with asbestos.

John Pickering and Partners LLP

John Pickering and Partners LLP is a specialist legal practice that has represented claimants in the leading asbestos "test cases" in the last ten years. The firm represented Sylvia Barker in Barker v Corus (UK) Plc, a case that highlighted the legal tactics of employers and insurers trying to cut back their compensation liabilities to mesothelioma sufferers, and which prompted the amendment of the Compensation Act 2006 to ensure full compensation for mesothelioma claims. The firm represented two of the three claimants in the Fairchild appeal, in which the insurance industry tried unsuccessfully to block compensation altogether for mesothelioma sufferers unable to identify which of two or more sources of asbestos exposure had caused their illness.

The firm represented Alice Jefferson, a mesothelioma sufferer, whose illness and compensation claim against Cape Asbestos were featured in the important documentary "Alice: A Fight For Life."  Shown by Yorkshire Television in July 1982, the programme was an important catalyst for legal change and public awareness of the plight of the victims of asbestos.

If you need advice about an asbestos related illness, contact us now for information about making a claim for compensation.

Sources:
http://www.medicinenet.com
www.thelancet.com
http://news.bbc.co.uk/1/hi/health/7402650.stm
http://google-sina.com/2008/05/16/chemotherapy-does-not-improve-treatment-for-mesothelioma-2/

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