Australian and US researchers recently published two studies showing therapeutic techniques which may improve the survival odds of malignant peritoneal mesothelioma patients — pineapple enzyme and a second round of HIPEC. While the first treatment remains highly experimental, second HIPEC rounds are already used by some cancer centers to treat qualified patients.
Pineapple Enzyme May Fight Peritoneal Mesothelioma
New evidence from Australia suggests that a pineapple enzyme may help improve the success rate of chemotherapy in fighing malignant peritoneal mesothelioma.
At the moment all forms of mesothelioma are considered highly aggressive cancers with attendant poor prognoses, largely due to the limited effectiveness of standard treatments like surgery and chemotherapy. However, an enzyme known as bromelain — which is derived from the pineapple — has been shown in other studies to help fight pancreatic and breast cancers.
Examining the potential of this enzyme as a mesothelioma-fighter, Australian researchers found it could also be toxic for malignant peritoneal mesothelioma cells. This mesothelioma-fighting ability appears to be even more effective when combined with the common mesothelioma chemotherapy agent cisplatin.
Bromelain works to fight cancer by triggering the breakdown of a protein known as MUC-1. This protein is found in a number of cancers, including mesothelioma, and it helps the cancer cells spread, invade, and resist chemotherapy.
When the Australian researchers tested various concentrations of bromelain, with and without assitance from chemotherapy drugs like 5-FU and cisplatin, they found the enzyme produced promising results.
Looking at mesothelioma cells 4 and 72 hours after treatment, the researchers noted that bromelain on its own affected mesothelioma on its own. Combined with a chemotherapy drug, however, bromelain was even more powerful — cisplatin and bromelain appeared to produce a synergistic effect. (5-FU did not appear to get any boost from bromelain.)
Examining the cells afterwards, the Australians noted that bromelain produced cell death in malignant peritoneal mesothelioma through programmed cell death (known as apoptosis) as well as a natural breaking down of cells into component parts (called autophagy). These results suggest that bromelain may make a promising new treatment for malignant peritoneal mesothelioma when combined with cisplatin chemotherapy.
Of course, bromelain will still need more testing to determine the treatment’s effectiveness and safety. Human bromelain trials will also aid doctors in determining how much bromelain to give their patients. Worth noting — though bromelain is currently sold over the counter as a dietary supplement, there’s currently no evidence the supplement enhances mesothelioma treatments. Mesothelioma patients thinking about using bromelain should discuss the idea with their doctors before they try it.
Second HIPEC Round Improves Malignant Mesothelioma Survival
While bromelain may help the effectiveness of malignant peritoneal mesothelioma chemotherapy, a different technique may help the effectiveness of surgery — performing part of the procedure twice.
That’s the conclusion of a group of US researchers, who looked at 29 patients undergoing surgery for malignant peritoneal mesothelioma. Those patients who had a second round of HIPEC — itself a component of the popular CRS/HIPEC mesothelioma treatment — tended to survive much longer. Whereas the median survival time for patients who had a single surgery and HIPEC round was 27.2 months, the median survival time for patients with a second HIPEC round was some 80 months.
Unfortunately the procedure still has a relatively high complication at 50%, even if the second round complication rate was lower than the 65% complication rate of first-time CRS/HIPEC. Nevertheless these results suggest a path to survival for malignant peritoneal mesothelioma patients.
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