According to a story from Healio, a recent phase 2 clinical trial found that treatment with vinorelbine plus active supportive care offered greater progression-free survival than active supportive care on its own in people living with relapsed malignant pleural mesothelioma. This is an aggressive type of cancer and relapse is expected in nearly all cases following standard chemotherapy regimens. For relapsed patients, a standard therapeutic regimen has yet to be established.
Mesothelioma is a rare and deadly cancer that originates from the lining of tissue that surrounds most of the body’s internal organs, called the mesothelium. Mesothelioma is best known as a type of cancer that commonly originates from exposure to asbestos, with over 80 percent of cases directly linked to such exposure. It most commonly appears in the lining of the lungs and chest wall, but can also occur around the heart, around the testes, and along the abdominal lining. Symptoms of mesothelioma are variable depending on the location, but may include chest pain, shortness of breath, fatigue, coughing, weight loss, and a swollen abdomen. Symptoms can develop slowly, and cancer often appears several decades after exposure. Mesothelioma responds poorly to treatment, with a five-year survival rate of around eight percent. Around 20,000 people in the United States get diagnosed every year. There is a dire need for more effective treatment options in this form of cancer. To learn more about mesothelioma, click here.
Vinorelbine is a chemotherapy agent that has been used for some time as a treatment primarily for lung cancer. It has also seen off-label use for other cancers as well, including mesothelioma. The trial included 154 patients from 10 sites across the United Kingdom. The patients who were treated with vinorelbine were given progressively increased doses in 21-day cycles. Median duration of treatment was 2.8 months. In the group treated with vinorelbine, median progression-free survival was 4.2 months, compared to 2.8 months for patients receiving just active supportive care.
During the course of the study, which took place from May 2016 to October 2018, 108 patients died. In the vinorelbine group, median survival was 9.3 vs 9.1 months. As would be expected with a chemotherapy agent, grade 3/4 adverse events were more prevalent in the vinorelbine group, including fatigue, dyspnea, and neutropenia. Overall, the trial indicates that the agent may be an effective and reasonably safe therapy that should be considered in relapsed melanoma.
The effectiveness of vinorelbine in malignant pleural mesothelioma was first reported over 20 years ago, but this is the first time the agent has been employed in a clinical trial for the disease.