A new Option for the Treatment of Malignant Pleural Mesothelioma (MPM)

Raltitrexed (Tomudex(R)) in combination with cisplatin in the treatment of MPM improves median overall survival compared to treatment with cisplatin alone.[1] With incidence rates expected to double over the next 20 years in many countries[2], new and effective treatments are a welcome addition, concluded an eminent panel of international speakers at a symposium sponsored by Hospira at the 35th congress of the European Society for Medical Oncology (ESMO), Milan. Mesothelioma is a form of cancer that affects the mesothelium, a thin membrane that lines the inner surface of the chest wall where it is known as the pleura. It also surrounds the organs found within this cavity, for example the heart and lungs.[3] Speakers at the symposium highlighted that whilst MPM - most commonly caused by exposure to asbestos - is a rare disease (the incidence is estimated to be 1.1-1.25 cases per 100,000 people), its incidence is expected to double over the next 20 years in many countries.[2]
Historically MPM has been treated with radiotherapy or surgery, despite minimal evidence to support these treatment options and both being associated with low success rates.[4,5,6] Speakers highlighted that over recent years the treatment of MPM has been simplified with the development of chemotherapy regimens as first-line treatment options.
Speakers referred to a clinical trial of first-line raltitrexed in combination with cisplatin, which showed that overall response rates in the raltitrexed group were higher compared to patients treated with cisplatin alone (23.6% vs. 13.6%; p=0.056).[1] Raltitrexed improved median overall survival by 2.8 months compared to patients treated with cisplatin alone (11.4 vs. 8.8 months; p=0.0483).[1] In addition, raltitrexed was associated with improved progression-free survival (5.3 vs. 4.0 months; p=0.058) compared to treatment with cisplatin alone.[1]
"MPM is a hard to treat, rare cancer with a poor prognosis. New treatment options such as a combination of cisplatin and raltitrexed, which improve patient outcomes with no detrimental effect on quality of life as compared to cisplatin alone are a welcome addition to our therapeutic portfolio," said Professor JP van Meerbeeck, professor of Thoracic Oncology at Ghent University, Belgium.
Treatment of MPM with chemotherapy regimens, including those that are cisplatin-based, is associated with a high incidence of neutropenia and anaemia. Neutropenia is the most serious haematological toxicity that occurs as a result of cancer chemotherapy and can lead to chemotherapy dose reductions and/or dose delays compared with the prescribed schedule.[7] Anaemia is associated with fatigue and poor quality of life. Supportive care to treat neutropenia and anaemia is therefore very important. Hospira has a broad oncology portfolio including supportive care drugs: Nivestim(TM) (filgrastim) and Retacrit(TM) (epoetin zeta), which are licensed for the treatment of chemotherapy-induced neutropenia and anaemia respectively.