Malignant Mesothelioma Treatment (PDQ®): Treatment - Health Professional Information [NCI] - Recurrent Malignant Mesothelioma
Treatment of patients with recurrent mesothelioma usually utilizes procedures and/or agents not previously employed in the initial treatment attempt. No standard treatment approaches have been proven to improve survival or control symptoms for a prolonged period of time. These patients should be considered candidates for phase I and II clinical trials evaluating new biologicals, chemotherapeutic agents, or physical approaches.[1,2,3,4,5,6] Patients with recurrent mesothelioma who have not received prior chemotherapy are candidates for first-line chemotherapy with cisplatinpemetrexed or cisplatin raltitrexed. (Refer to the Advanced Malignant Mesothelioma (Stages II, III, and IV) section of this summary.) However, patients with recurrent mesothelioma who receive surgery, or at least do not receive chemotherapy as part of the primary treatment and recur subsequently, are candidates for chemotherapy.
A large, randomized study compared pemetrexed to best supportive care in 243 patients who received one prior regimen of chemotherapy that did not include pemetrexed.[Level of evidence: 1iiA] No survival benefit was shown in patients who received pemetrexed, although the progression-free survival rate, time-to-progression, and the response rates favored the pemetrexed arm.
If a routine physical exam reveals swollen lymph nodes above the collarbone, a mass in the abdomen, weak breathing, abnormal sounds in the lungs, dullness when the chest is tapped, abnormalities of the pupils, weakness or swollen veins in one of the arms, or even changes in the fingernails, a doctor may suspect a lung tumor. Some lung cancers produce abnormally high blood levels of certain hormones or substances, such as calcium. If a person shows such evidence and no other cause is apparent, a doctor...
Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with recurrent malignant mesothelioma. The list of clinical trials can be further narrowed by location, drug, intervention, and other criteria.
General information about clinical trials is also available from the NCI Web site.
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