A large study on mesothelioma conducted by doctors in the United Kingdom and Australia and published in this month’s issue of The Lancet suggests that adding chemotherapy to established methods of symptom management does not appear to enhance the quality of life or survival of patients suffering from the aggressive disease.

Richard Stephens of the Medical Research Council (MRC) Clinical Trials Unit, one of the authors of the study, said: “While thousands are and will be affected by this deadly disease, our trial, which is one of the few large trials ever conducted in this disease, emphasizes how difficult mesothelioma is to treat. This is mainly because mesothelioma forms in the lining of the lung. This makes it hard to target. Although one of the chemotherapy drugs we looked at, vinorelbine, showed some promise, blanket chemotherapy may not be the way forward. Whilst continuing to try to palliate symptoms and improve quality of life we probably need to concentrate on developing tailored and targeted treatments to improve survival”

Kate Law, Cancer Research UK’s director of clinical trials, added: “Mesothelioma is very difficult to treat and treatment options are limited. These results showed no real benefit from adding these chemotherapy drugs compared with just treating the symptoms of the disease. Any treatment can have serious side effects for patients and these findings highlight that people should not have treatment that is not of proven benefit. Studies like this mean that patients and their doctors can make better informed decisions about the advantages and disadvantages of treatments.”

The study involved 409 patients with malignant pleural mesothelioma from 76 treatment centers in the UK and two in Australia. About a third of the participants received only active symptom control (ASC). Another third received ASC plus MVP chemotherapy (four cycles of mitomycin, vinblastine, and cisplatin every three weeks). The remaining patients received ASC plus vinorelbine chemotherapy (one injection of vinorelbine every week for 12 weeks). The patients’ progress was monitored regularly by the study team.

The United Kingdom has one of the highest rates of mesothelioma in the world. About 2,000 individuals die of the disease each year in the UK. Experts in that country say those numbers continue to rise. Australia posts similar figures.

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