Activity of intrapleural recombinant gamma-interferon in malignant mesothelioma

Article Abstract:

Malignant mesothelioma arises in the pleural lining of the chest cavity. Although the cancer is rare, it is increasing in incidence. Malignant mesothelioma can be caused by asbestos exposure and its increasing incidence reflects increases in the use of this substance. Conventional treatments are ineffective, and malignant mesothelioma is uniformly fatal. Substances that modulate the immune system have attracted the interest of researchers attempting to treat cancers that respond poorly to conventional treatments. Of particular interest are the interferons, which have been shown in some experiments to have a direct effect on tumor cells themselves. Gamma-interferon was used in the experimental therapy of 19 patients with malignant mesothelioma. Nine patients had Stage IA disease, in which the cancer is limited to the pleural membrane of the diaphragm or of the sides of the chest cavity. Eight patients had Stage IIA disease and two had Stage IIB disease (more advanced conditions). All patients experienced fever as a result of interferon treatment; chills, malaise, vomiting, and itching were common side effects. Four complete responses were obtained with interferon gamma treatments; all four of these responses occurred in patients with Stage IA disease and with tumor nodules smaller than 5 millimeters. Two partial responses were also observed: one in a Stage IA patient and one in a Stage IIB patient. Two of the patients achieving a complete response are disease-free after 16 and 25 months of follow-up. One of the patients who achieved a partial response remains stable after 31 months. Average survival times for this type of cancer typically vary from 9 to 15 months. These encouraging results indicate that interferon gamma may have a useful therapeutic effect in cases of malignant mesothelioma. However, only early stage disease with small tumor nodules may be expected to respond. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Drug therapy, Interferon gamma

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Tumor cells in intraoperative pleural lavage: an indicator for the poor prognosis of bronchogenic carcinoma

Article Abstract:

Tumor cells may be present in the pleural cavity of patients who have undergone surgery for bronchogenic carcinoma. There is some uncertainty about whether the presence of these tumor cells represents a natural process or whether these cells contaminate the pleural cavity as a consequence of their release during surgery. To clarify this point, the pleural cavities were rinsed with physiological saline before and after surgery in 59 patients with bronchogenic carcinoma and 21 control patients with noncancerous disease. The control patients were all negative for tumor cells. Examination of the lavage fluid revealed that 27 bronchogenic carcinoma patients had tumor cells in the lavage fluid prior to surgery and 2 patients had tumor cells in the lavage fluid after surgery. The presence of the tumor cells in the lavage fluid before surgery clearly indicates that this dispersion of cells is a part of the normal disease process. It is still not clear, however, if the cancer cells present in the two patients after surgery represent a surgical artifact, or not. Two-year survival data indicate that the presence of tumor cells in the lavage fluid has a significant negative prognostic impact. Forty percent of the patients with positive lavage findings were alive after two years. This contrasts with a two-year survival rate of 97 percent among those patients whose lavage fluid was free of tumor cells. The results suggest that the examination of pleural lavage should be performed in cases of bronchogenic carcinoma. (Consumer Summary produced by Reliance Medical Information, Inc.)

Lung cancer, Irrigation (Medicine)

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A Phase II study of pirarubicin in malignant pleural mesothelioma

Article Abstract:

Pleural mesothelioma, a rare cancer, is almost certainly the result of asbestos exposure. The worldwide use of asbestos has resulted in some increase in the incidence of this disease. Unfortunately, much of the treatment of malignant mesothelioma is palliative, and no therapeutic regimen has been shown to significantly improve survival. The anticancer activity of pirarubicin was evaluated in 35 patients with this recalcitrant tumor. Pirarubicin is a member of a class of drugs called anthracyclines, which includes the anticancer agents mitoxantrone and doxorubicin. Indeed, the major metabolite of pirarubicin within the body is doxorubicin. However, the toxicity of pirarubicin for the heart is less than that of mitoxantrone and doxorubicin, and some chemical features suggest that the compound may prove more effective in some cases. Of the 35 patients, only 3 achieved a partial response; there were no complete responders to the drug. The median survival time of the patients was 10.5 months. Pirarubicin was observed to produce fewer side effects than doxorubicin, and since its effectiveness is comparable, it should be considered for the treatment of malignant mesothelioma. (Consumer Summary produced by Reliance Medical Information, Inc.)

Physiological aspects, Anthracyclines, Chemotherapy

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