Mesothelioma Treatment Center opens study of new treatment

The Baylor College of Medicine Mesothelioma Treatment Center (MTC) at St. Luke's Health–Baylor St. Luke's Medical Center (Baylor St. Luke's) has begun enrolling patients in a clinical research study for patients with malignant pleural mesothelioma that will investigate the use of two chemotherapy drugs delivered directly to the chest during surgery.

Malignant pleural mesothelioma is a rare, aggressive cancer that develops in the thin layer of tissue (called the pleura) that surrounds the lungs, and is caused primarily by the inhalation of asbestos fibers. Treatment for the disease is typically a combination of surgery and chemotherapy and/or radiation therapy.

“Even after aggressive treatment with surgery, chemotherapy and/or radiation, recurrence is common. This study expands on what we already know about surgery and chemotherapy for mesothelioma and combines them in a new way – giving complete standard-of-care chemotherapy directly into the chest where we can potentially maximize its benefits while minimizing its side effects with the goal of reducing recurrence rates and improving survival and quality of life,” said Dr. Shawn Groth, assistant professor of surgery at Baylor and principal investigator of the study.

Most recurrences of mesothelioma after initial treatment occur on the same side of the chest as the original tumor, indicating a need for better local tumor control, Groth said. Delivering chemotherapy directly to the tumor site in the chest during surgery already is being done at the Mesothelioma Treatment Center for more effective treatment.

“When we give hot chemotherapy directly into the chest at the time of surgery, we are able to give higher doses than what we can give intravenously because of lower toxic effects on the whole body. The heated chemotherapy fluid is effective at killing cancer and making chemotherapy work better,” Groth said.

Researchers at the Mesothelioma Treatment Center have shown that giving the cancer drug cisplatin by itself through heated chemotherapy during surgery offers a survival benefit for some patients. It's also been shown that the combination of cisplatin and another drug, pemetrexed, is more effective than cisplatin alone when delivered through standard IV chemotherapy. However, what's not known, Groth said, is whether this combination of cisplatin and pemetrexed is effective when given directly into the chest.

This phase I study will start to answer that question by determining the maximum tolerated dose of intrathoracic administration (delivery directly to the chest during surgery) of pemetrexed when given in conjunction with cisplatin in patients with malignant pleural mesothelioma.

“This clinical trial is only one of many mesothelioma treatment protocols available at the Mesothelioma Treatment Center and builds on a strong foundation of mesothelioma research at Baylor College of Medicine,” said Dr. David Sugarbaker, professor of surgery and chief of thoracic surgery at Baylor and director of the Mesothelioma Treatment Center, who is leading the study along with Groth. “Our direct affiliation with the Dan L. Duncan Comprehensive Cancer Center, a NCI-designated Comprehensive Cancer Center, facilitates innovative and sophisticated research protocols such as this one.”

Details about this clinical study can be found online. Patients and caregivers interested in enrolling in the study may contact the Mesothelioma Treatment Center at Baylor College of Medicine at mesotreatmentcenter.org or call 713-798-6376 for more information.

The Mesothelioma Treatment Center is part of the Baylor College of Medicine Lung Institute at Baylor St. Luke's Medical Center. It brings together a multidisciplinary team of surgeons, oncologists, radiologists, pathologists and other healthcare professionals from Baylor College of Medicine, the NCI-designated Dan L. Duncan Comprehensive Cancer Center at Baylor and Baylor St. Luke's Medical Center, the private adult hospital jointly owned by Baylor and St. Luke's Health System.