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Single-Agent Chemotherapy in Mesothelioma treatment
Single-agent chemotherapy is a cancer treatment that is carried out by using only one drug, a single agent.
The aim of the chemotherapy is to destroy cancer cells all over the body with help of the drugs. The most common mesothelioma treatment is carried out by placing chemotherapy drugs directly into a vein (IV or intravenous). Direct delivery of the chemotherapy drugs to the abdomen or the chest (intraperitoneal or intrapleural delivery) is also studied now.
Most popular Single agents:
Doxorubicin is the most commonly applied single-agent and it has been used for a long time. There are some new medicines which are now preferably used and combined with other drugs. Here are some of them: carboplatin, cisplatin, cyclophosphamide, epirubicin, gemcitabine, ifosfamide, methotrexate, paclitaxel, and vinorelbine.
Chemotherapy or palliative care are in most cases the only way out for mesothelioma patients as far as the majority cannot be treated with surgery or RT. The single-agent treatment has given the low response rate, from 10% to 20% on average, though it is easy to apply as far as it uses cytotoxic agents that are available commercially, like cisplatin, doxorubicin, trimetrexate, as well as taxanes like docetaxel and paclitaxel. Despite the frequent investigation of doxorubicin, cisplatin has resulted as the most active drug after meta-analysis.
Newer compounds like liposomal doxorubicin, daunorubicin (a.k.a. liposomal anthracyclines), gemcitabine, and pemetrexed, used in single-agent chemotherapy have not given any considerable results either. Despite the average response rate 14% of antifolate pemetrexed and general inactivity of the drugs described above, the nucleoside analogue gemcitabine shows the response rate up to 31% during the second phase data.
The toxicity of chemotherapy drugs is high, so that they cause various side effects like including nausea, exhaustion, anorexia, hair loss, and vomiting. Certain side effect are dependant on the kind of the drug that is applied during the chemotherapy procedure.
During single-agent therapy cancer is treated using only one drug. The success of applying any single-agents is insignificant during Mesothelioma treatment. The most studied agent, doxorubicin, along with detorubicin, pirarubicin, and epirubicin gives a 15-percent response rate.
Close response rate, 10-20% is given by a number of other agents, like carboplatin, mitomucin, cyclophosphamide, and ifosdamide. The approximate 14% response rate was discovered after a number of trials carried out over cisplatin. During one of the trials that was held wish high-dose density a response rate of 36% was reached, but this result was maintained only from 2 to 8 months.
The researches got down to studying combinations of agents due to the dramatically low response rate of the single-agent chemotherapy (less than 20%) for Mesothelioma patients. Up to 44% response rate was reached in combinations of the following drugs: bleomycin, cisplatine, doxorubicin, and mitoxantrone. Though, such response rate are not stable so that the average results of combination therapy and single-agent therapy are close.
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