A case of advanced malignant pleural mesothelioma treatment with chemotherapy and photodynamic therapy

Our plain-English summary of A case of advanced malignant pleural mesothelioma treatment with chemotherapy and photodynamic therapy, by J.W. Ryu, Y.S. Kim (Tuberculosis and Respiratory Diseases, 2015).

The study

• Authors: J.W. Ryu, Y.S. Kim
• Journal: Tuberculosis and Respiratory Diseases
• Published: 2015;78(1):36-40
• Cited by: 4 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Malignant pleural mesothelioma (MPM) is an aggressive, treatment-resistant, and generally fatal disease. A 68-year-old male who was diagnosed with MPM at another hospital came to our hospital with dyspnea. We advised him to take combination chemotherapy but he refused to take the treatment. That was because he had already received chemotherapy with supportive care at another hospital but his condition worsened. Thus, we recommended photodynamic therapy (PDT) to deal with the dyspnea and MPM. After PDT, the dyspnea improved and the patient then decided to take the combination chemotherapy. Our patient received chemotherapy using pemetrexed/cisplatin. Afterwards, he received a single PDT treatment and then later took chemotherapy using gemcitabine/cisplatin. The patient showed a survival time of 27 months, which is longer than median survival time in advanced MPM patients. Further research and clinical trials are needed to demonstrate any synergistic effect between the combination chemotherapy and PDT.

In plain English

This was a case report from Korea on photodynamic therapy (PDT), a light-activated drug treatment, for advanced malignant pleural mesothelioma. The patient, a 68-year-old man, had been diagnosed by biopsy at another hospital, where chemotherapy had not improved his symptoms. The article states his job had nothing to do with asbestos, and he had a 30 pack-year smoking history. Scans showed a right-sided chest mass about 11.5 by 16 cm, with spread to lymph nodes and bone. He first refused more chemotherapy and received PDT, after which his breathlessness improved without observed complications. Six cycles of pemetrexed and cisplatin followed, with no significant change in tumor volume, and he stayed relatively stable for 6 months. After progression, a second PDT improved symptoms and he stayed stable for 9 months, though the mass did not shrink significantly. A third PDT was not done for financial reasons, and later gemcitabine and cisplatin gave no dramatic response. He died 27 months after initial diagnosis. The authors called for further research on combining PDT with chemotherapy.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: case report (single patient), presented with a review of available literature
• Who was studied: One 68-year-old man with advanced malignant pleural mesothelioma treated at Dankook University College of Medicine, Cheonan, Korea. He had been diagnosed by thoracoscopic biopsy at another university hospital.
• Exposure: No asbestos exposure through work was reported. The article states his job had nothing to do with asbestos. He had a 30 pack-year smoking history.
• Main results:
  • At admission, CT showed a right-sided mass of about 11.5 by 16 cm with pleural effusion and spread within the pleura. Bone scan showed metastasis to a rib and the lumbar spine.
  • After the first PDT, the patient's breathlessness (dyspnea) improved and no complications were observed.
  • After six cycles of pemetrexed/cisplatin, tumor volume showed no significant interval change. The patient remained relatively stable for 6 months after multimodality therapy.
  • After disease progression at 7 months, a second PDT improved symptoms without significant decrease in mass volume. The patient remained stable without further treatment for 9 months.
  • A third PDT was not performed for financial reasons. Gemcitabine/cisplatin chemotherapy did not produce a dramatic response, and the patient died 27 months after initial diagnosis.
• The authors' conclusion: The authors suggested that PDT combined with other existing treatments could be applied as an option for advanced malignant pleural mesothelioma to improve symptoms and extend survival time.
• Limitations the authors state:
  • The authors stated that further research and clinical trials are needed to demonstrate any synergistic effect between combination chemotherapy and PDT.

Topics

Medical terms in this study, explained in our Lexicon: Pleural Mesothelioma, Chemotherapy, Dyspnea, Pemetrexed (Alimta), Cisplatin, Gemcitabine, Median Overall Survival, Clinical Trial.

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