A recent mesothelioma study compared three different methods of evaluating chemotherapy effectiveness in mesothelioma and found one method to be more effective than the others.
Experts in the field of mesothelioma will attest that measuring tumor response to chemotherapy is especially difficult because tumors of this cancer follow a non-spherical growth pattern along the pleural surface of the lung, which is challenging to evaluate. An accurate method for measuring tumor response is important to all cancer treatment as it helps doctors assess the treatment’s ability to reduce the size and growth of the tumor. Thus, finding a successful method of measuring chemotherapeutic effect in mesothelioma is very important to improving mesothelioma treatment.
Considering the added challenge of measuring the non-spherical mesothelioma tumors, finding an accurate method of measuring tumors is crucial to improving patient prognosis and survival. Presently, the average life span of a mesothelioma patient is four to 18 months after diagnosis. Improvements in trimodality therapy (using three different treatments, including surgery, chemotherapy and radiation) are increasing survival rates among some mesothelioma patients, offering hope to those diagnosed with this aggressive cancer.
The researchers stated, “There is no ‘gold standard’ technique for tumor measurement in MPM [malignant pleural mesothelioma]. Bi-dimensional response criteria established by the World Health Organization (WHO) have been used for many years. However, WHO criteria are poorly suited to the growth pattern of MPM and insufficient for some patients.”
Another method, known as modified RECIST (Response Evaluation Criteria in Solid Tumor), has become the standard method for mesothelioma tumor analysis. But investigators of this method have identified weaknesses that have resulted in over-classification of tumors. Additionally, interpretation of the data can vary greatly from doctor to doctor, yet another variable that compromises the method’s accuracy.
The study proposed “that indefinable shapes can be represented as spheres with defined volumes, thereby allowing three-dimensional evaluation of the chemotherapy response.” Results from the study supported the researchers’ three-dimensional method over the WHO and RECIST methods.
The researchers concluded, “When considering the non-spherical growth pattern of tumor and the difficulty in choosing target lesion, the most reliable approach for evaluation of tumor response in mesothelioma might be direct measurement of tumor volume change in three dimensions as completely as possible… We recommend the use of our method for determining the chemotherapy response in mesothelioma cases. ”
Additional information on mesothelioma and chemotherapy may be found through the Mesothelioma Center.
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