Platinum-Based Chemotherapy

Platinum-based chemotherapeutic agents are the most commonly used chemotherapy drugs in mesothelioma patients. Studies show that these drugs, like carboplatin and cisplatin, are advantageous because they may help extend a life span by as much as one year longer than other chemotherapy treatments. Studies show similar trends with these platinum-based drugs in some lung cancer patients.

Despite their overall success, platinum medications have limited efficacy. Patients universally build up a tolerance to the type of drug, and it is less effective with continued use. As of now, doctors are still trying to find a way around this problem to keep the medication working against cancer.

How Platinum-Based Chemotherapy Works

Like most chemotherapy drugs, platinum-based chemotherapy agents are usually administered intravenously. And similar to other forms of chemotherapy, platinum drugs target cells that are rapidly dividing. The platinum binds to cells' DNA and prevents cancer cells from repairing themselves, eventually leading to their deaths.

This type of drug has best results early in the treatment regimen. Over time, cancer cells including mesothelioma cells build up a tolerance to this type of drug and strengthen their repair mechanisms. The cells become more resistant to platinum's interference, making such drugs work less successfully. Researchers are currently working on ways to avoid or overcome the tolerance buildup. In one avenue of research, doctors are studying the key proteins in cancer cells that help to build up a resistance, with the hopes of understanding and preventing a weakened chemotherapy effect.

Study Results of Platinum-Based Chemotherapy

Platinum-based chemotherapy is used so commonly in mesothelioma patients because clinical studies show it improves survival times. In a 2010 study, researchers analyzed 14 peritoneal mesothelioma patients who underwent chemotherapy treatment. All patients received platinum-based cisplatin along with a non-platinum chemotherapy agent: gemcitabine, doxorubicin or pemetrexed. Overall, the platinum-based regimen caused a median survival of 20.1 months, more than double the typical peritoneal mesothelioma survival of seven to nine months.

Another study reviewed the efficacy of platinum chemotherapy in 5530 small cell lung cancerpatients. Although any type of lung cancer is most commonly a result of smoking, between two and 12 percent of the cases are asbestos-related. Researchers studied survival rates at 6, 12 and 24 months, designated short-, intermediate- and long-term survival rates, respectively. At each interval, survival rates were comparable for platinum and non-platinum chemotherapy treatments. At six months, 69 percent of patients receiving platinum-based therapy were alive, compared to 67 percent of patients receiving other chemotherapy. At one and two years, survival times in both groups kept the same trend, with platinum-based chemotherapy showing negligibly better results.

A similar study of non-small cell lung cancer (NSCLC) produced results more strongly in favor of a platinum-based approach. In the 2004 review of 7,633 (NSCLC) patients, researchers found that 34 percent of platinum-receiving patients survived one year, as compared to 29 percent of patients receiving non-platinum chemotherapy treatment.

Alternatives to Platinum-Based Chemotherapy

When planning a treatment regimen, doctors may consider or recommend any number oftreatment options for mesothelioma, with platinum-based chemotherapy being only one option. Alternative or further chemotherapy drugs may be considered, as well as surgery, radiation therapy and new types of treatments.