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Platinum-based Doublet Chemotherapy In Pre-treated Malignant Pleural Mesothelioma (MPM) Patients: A Mono-institutional Experience.

G. Pasello, S. Nicotra, G. Marulli, F. Rea, L. Bonanno, P. Carli, C. Magro, A. Jirillo, A. Favaretto
Published 2011 · Medicine

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BACKGROUND The major clinical problems of MPM management are the short duration of response and the early relapse. Currently, after the first-line standard pemetrexed/platinum combination there is not a defined regimen for the second line treatment of MPM, and the clinical benefits in fit patients are uncertain. We analyzed the feasibility of gemcitabine/platinum chemotherapy in pretreated MPM patients. METHODS Eligible patients should have relapsed after first-line chemotherapy with pemetrexed plus cisplatin (24%) or carboplatin (76%); 53% of the patients had previously received trimodality treatment, 18% neoadjuvant chemotherapy followed by pleurectomy/decortication, 29% were inoperable. Patients had to have PS=0-2, adequate organ function, measurable disease. Chemotherapy was gemcitabine 1000 mg/m(2) days 1, 8 associated to the alternative platinum compound respect to 1st line, i.e. cisplatin 75 mg/m(2) or carboplatin AUC 5 day 1 every 3 weeks, for 3-6 cycles. Baseline staging and reassessment after cycles 3 and 6 were performed with CT-scan. RESULTS Since 2006 17 relapsed MPM patients were referred to our centre. Patients were 12 males and 5 females; median age: 61 years (range 47-74); histology: 12 epithelial, 4 sarcomatoid and 1 biphasic. PS 1-2 (15:2). The combination of gemcitabine with carboplatin/cisplatin was administered as second line treatment in 13 (76%) patients, as third line in 4 (24%) patients. Two patients were lost to follow-up without re-evaluation, therefore radiologic and clinical response was assessable in 15 (88%) patients. Among evaluable patients 10 (67%) showed stable disease and 5 (33%) progressive disease. Symptoms improved in 8 (53%) cases. In the intent-to-treat population median survival was 28 weeks (range 13-168) and median time-to-treatment failure 15 weeks (range 3-75). Toxicity profile showed 2 (13%) grade 4 and 6 (40%) grade 3 thrombocytopenia, 4 (27%) grade 3 leucopenia, 3 (20%) grade 3 anaemia and 6 (40%) of grade 3 neutropenia. Grade 3 non haematological toxicities were nausea (14%) and asthenia (21%). CONCLUSION Gemcitabine-platinum regimens are able to control symptoms and disease progression with a modest toxicity profile. The present results from a small series of patients should be confirmed by a prospective trial in a larger cohort of patients.
This paper references
10.1200/JCO.2006.09.9887
Phase III trial of pemetrexed plus best supportive care compared with best supportive care in previously treated patients with advanced malignant pleural mesothelioma.
J. Jassem (2008)
10.1200/JCO.2003.11.136
Phase III study of pemetrexed in combination with cisplatin versus cisplatin alone in patients with malignant pleural mesothelioma.
N. Vogelzang (2003)
10.1016/j.ctrv.2009.09.003
Second-line treatment for malignant pleural mesothelioma.
G. Ceresoli (2010)
10.1200/JCO.2007.25.18_SUPPL.18198
Pemetrexed in second-line therapy in patients with malignant pleural mesothelioma
M. Serke (2007)
10.1016/S1556-0864(15)30351-8
Pemetrexed Alone or in Combination with Cisplatin in Previously Treated Malignant Pleural Mesothelioma: Outcomes from a Phase IIIB Expanded Access Program
P. Jänne (2006)
10.1016/J.LUNGCAN.2007.09.018
Gemcitabine and cisplatin in unresectable malignant mesothelioma of the pleura: a phase II study of the Southwest Oncology Group (SWOG 9810).
S. Kalmadi (2008)
10.1016/J.LUNGCAN.2007.08.031
Retreatment with pemetrexed-based chemotherapy in malignant pleural mesothelioma (MPM): a second line treatment option.
A. Razak (2008)
10.1093/ANNONC/MDI187
Second-line (post-study) chemotherapy received by patients treated in the phase III trial of pemetrexed plus cisplatin versus cisplatin alone in malignant pleural mesothelioma.
C. Manegold (2005)
10.1016/J.LUNGCAN.2007.02.004
Induction chemotherapy, extrapleural pneumonectomy (EPP) and adjuvant hemi-thoracic radiation in malignant pleural mesothelioma (MPM): Feasibility and results.
F. Rea (2007)
10.1097/JTO.0b013e31817c73ec
Single-Agent Pemetrexed for Chemonaïve and Pretreated Patients with Malignant Pleural Mesothelioma: Results of an International Expanded Access Program
Paul Taylor (2008)
10.1097/01.coc.0000144852.75613.56
Cisplatin and Gemcitabine in Malignant Pleural Mesothelioma: A Phase II Study
B. Castagneto (2005)
10.1038/ncb0809-921
SASPense and DDRama in cancer and ageing
M. Fumagalli (2009)
10.1097/JTO.0B013E31802F3813
Pemetrexed as Second-Line Treatment in Malignant Pleural Mesothelioma after Platinum-Based First-Line Treatment
J. Sørensen (2007)
10.1200/JCO.2008.17.5604
Trimodality therapy with induction chemotherapy followed by extrapleural pneumonectomy and adjuvant high-dose hemithoracic radiation for malignant pleural mesothelioma.
M. D. de Perrot (2009)
10.1016/S0169-5002(05)80890-6
P-397 Response of malignant pleural mesothelioma to chemotherapy does not confer a survival advantage
D. Fennell (2005)
10.1200/JCO.1997.15.6.2403
Improvements in survival and clinical benefit with gemcitabine as first-line therapy for patients with advanced pancreas cancer: a randomized trial.
H. Burris (1997)
10.1093/ANNONC/MDH059
Modified RECIST criteria for assessment of response in malignant pleural mesothelioma.
M. Byrne (2004)
10.1016/j.rmed.2009.07.019
Pemetrexed in the treatment of malignant mesothelioma: results from an expanded access program in Germany.
M. Reck (2010)
10.1200/JCO.20005.14.589
Randomized phase III study of cisplatin with or without raltitrexed in patients with malignant pleural mesothelioma: an intergroup study of the European Organisation for Research and Treatment of Cancer Lung Cancer Group and the National Cancer Institute of Canada.
J. Van Meerbeeck (2005)
10.1038/sj.bjc.6600118
Multicentre phase II study of gemcitabine and cisplatin in malignant pleural mesothelioma
J. van Haarst (2002)
10.1038/sj.bjc.6600505
A multicentre phase II study of cisplatin and gemcitabine for malignant mesothelioma
A. Nowak (2002)
10.1002/cncr.23337
Gemcitabine and vinorelbine in pemetrexed‐pretreated patients with malignant pleural mesothelioma
P. Zucali (2008)
10.2174/138945009789753200
Molecular targets in malignant pleural mesothelioma treatment.
G. Pasello (2009)
10.1200/jco.2010.28.15_suppl.e18106
Retreatment with pemetrexed-based chemotherapy (PBC) in patients with malignant pleural mesothelioma (MPM): An observational study.
F. D. Vincenzo (2010)
10.1002/cncr.11405
Gemcitabine combined with carboplatin in patients with malignant pleural mesothelioma
A. Favaretto (2003)
10.1186/1745-6673-3-34
Gemcitabine combined with oxaliplatin in pretreated patients with malignant pleural mesothelioma: an observational study
A. Xanthopoulos (2008)



This paper is referenced by
10.1016/j.ccm.2012.12.005
Malignant pleural mesothelioma: update on treatment options with a focus on novel therapies.
A. Haas (2013)
on Novel Therapies
Andrew R. Haas (2013)
10.1186/1756-0500-5-482
Re-challenge with pemetrexed in advanced mesothelioma: a multi-institutional experience
A. Bearz (2011)
10.7314/APJCP.2013.14.6.3887
Secondline chemotherapy versus best supportive care in patient with malignant pleural mesothelioma: a retrospective study.
H. Mutlu (2013)
10.18632/oncotarget.5974
MDM2 and HIF1alpha expression levels in different histologic subtypes of malignant pleural mesothelioma: correlation with pathological and clinical data
G. Pasello (2015)
10.2217/LMT.14.17
Second-line treatment in malignant pleural mesothelioma: translating the evidence into clinical practice
G. Ceresoli (2014)
10.1007/s13665-012-0010-4
Emerging therapies for malignant pleural mesothelioma
J. Quispel-Janssen (2012)
HMGB-1 Release and the CD8+ T Cell Response Elicited by Radiation Treatment in Malignant Pleural Mesothelioma
Matthew Wu (2015)
10.1097/JTO.0000000000000198
Synergistic Antitumor Activity of Recombinant Human Apo2L/Tumor Necrosis Factor-Related Apoptosis-Inducing Ligand (TRAIL) in Combination with Carboplatin and Pemetrexed in Malignant Pleural Mesothelioma
G. Pasello (2014)
10.1016/j.rmed.2018.06.026
A systematic review and meta-analysis of second-line therapies for treatment of mesothelioma.
F. Petrelli (2018)
10.1007/978-3-030-16884-1_15
Role of Chemotherapy in the Management of Malignant Pleural Mesothelioma
L. Gianoncelli (2019)
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