Malignant peritoneal mesothelioma. Is there a new treatment?

Our plain-English summary of Malignant peritoneal mesothelioma. Is there a new treatment?, by K.I. Rasul, D.J. Kerr (Rare Tumors, 2009).

The study

• Authors: K.I. Rasul, D.J. Kerr
• Journal: Rare Tumors
• Published: 2009;1(2):e49
• Type of article: Case report
• Read it: PubMed · Publisher · Free full text

Abstract

The authors report a novel, alternative approach to treat malignant peritoneal mesothelioma (MPeM) targeting, vascular endothelial growth factor (VEGF) using anti-VEGF (bevacizumab) chemotherapy combination.

In plain English

This article was a case report by doctors in Doha, Qatar, describing one patient with malignant peritoneal mesothelioma, a cancer of the lining of the abdomen. In June 2008 a 60-year-old Jordanian man came in with a swollen abdomen and a hernia near the navel. Tissue from his hernia repair, with special stains, gave the diagnosis. The article did not report whether he had been exposed to asbestos. He was first given cisplatin plus pemetrexed after about 10 liters of abdominal fluid were drained, but he still needed 6-8 liters drained with each cycle. Gemcitabine plus pemetrexed, and cisplatin given into the abdomen, also did not stop the fluid returning. In January 2009 he started gemcitabine plus bevacizumab, a drug aimed at a blood-vessel growth signal called VEGF. From the first cycle he needed no drainage until August 2009, and he kept working. A July 2009 CT scan showed that the thickening of the abdominal lining had resolved. He had mild nosebleeds. The authors concluded that this combination could be an effective alternative and called for further clinical studies.

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)
• Who was studied: One 60-year-old Jordanian man with malignant peritoneal mesothelioma who presented in June 2008. He also had high blood pressure, diabetes and high blood fats. The authors were based in Doha, Qatar.
• Exposure: The article reports no asbestos exposure history for the patient. What it describes are chemotherapy treatments: cisplatin plus pemetrexed; gemcitabine plus pemetrexed; cisplatin given into the abdomen; and finally gemcitabine 1250 mg/m2 plus bevacizumab 5 mg/kg every 2 weeks.
• Main results:
  • Tissue examination and immunostaining gave a diagnosis of malignant peritoneal mesothelioma in this patient.
  • On first-line cisplatin plus pemetrexed, the patient still needed about 6-8 liters of abdominal fluid drained with each cycle, despite some shrinkage of lymph nodes on CT.
  • Gemcitabine plus pemetrexed for 2 cycles, and cisplatin given into the abdomen, did not stop the fluid from building up again.
  • On gemcitabine plus bevacizumab, the patient received 6 cycles. He needed no fluid drainage until August 2009 (7 months after starting) and kept his job during this period.
  • A CT scan in July 2009 showed the peritoneal thickening had resolved. The same scan showed swelling of the right kidney from blocked urine flow (hydronephrosis).
  • The patient had mild nosebleeds (epistaxis), which were managed by local pressure.
• The authors' conclusion: The authors concluded that this case shows bevacizumab in combination chemotherapy could be an effective alternative treatment for patients not responding to other proven agents. They said further clinical studies are needed to establish its role.

Topics

Medical terms in this study, explained in our Lexicon: Peritoneal Mesothelioma, Bevacizumab, Chemotherapy.

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