Online citations, reference lists, and bibliographies.
← Back to Search

Relapse Pattern And Second-line Treatment Following Multimodality Treatment For Malignant Pleural Mesothelioma.

Arthur Kostron, M. Friess, Ornella Crameri, I. Inci, D. Schneiter, S. Hillinger, R. Stahel, W. Weder, I. Opitz
Published 2016 · Medicine

Cite This
Download PDF
Analyze on Scholarcy
Share
OBJECTIVES To analyse the relapse pattern and influence of second-line treatment after recurrence of malignant pleural mesothelioma (MPM) in patients who had previously undergone multimodality treatment. METHODS Between September 1999 and December 2013, 136 patients underwent macroscopic complete resection (MCR) by extrapleural pneumonectomy after induction chemotherapy for MPM. We analysed 106 patients who presented with recurrent disease until October 2014. Data were retrieved from our mesothelioma database, with additional information regarding precise localization gathered by reviewing the imaging and medical records. RESULTS The overall recurrence rate was 78% (106/136 patients). The median freedom from recurrence was 9 months after surgery [95% confidence interval (95% CI) 7-10]. Local recurrence only was observed in 33 patients (31%), distant metastases only in 27 patients (26%) and simultaneous distant and local recurrence in 46 patients (43%). Local recurrence was observed significantly less frequently in patients having received adjuvant radiotherapy (19 vs 47%, P = 0.003), but there was no significant impact on overall survival (OS) [radiation: 22 months (95% CI 19-24); no-radiation: 23 months (95% CI 18-27), P = 0.6]. The median OS was 22 months (95% CI 21-24), median post-recurrence survival (PRS) was 7 months (95% CI 5-9) and patients with local recurrence only survived significantly longer (12 months, 95% CI 8-16) compared with patients with distant recurrence only (5 months, 95% CI 2-8) or distant plus local relapse (6 months, 95% CI 3-9; P = 0.04). A total of 78 patients received a second-line therapy after tumour recurrence: chemotherapy (n = 48), local radiotherapy (n = 9), surgery (n = 10) or a combination thereof (n = 11). Patients undergoing second-line treatment survived significantly longer compared with patients not receiving therapy (P < 0.0005). The median PRS after surgery was significantly longer than that of patients receiving chemo-, radio- or chemo-radiotherapy (P = 0.04). CONCLUSIONS Local recurrence of MPM remains the most frequent type of relapse even after multimodality treatment including MCR. In the present cohort, active treatment seems beneficial to the patient since surgical excision of local tumour relapse has good long-term outcome in selected patients. Thus, second-line treatment may prolong PRS; however, these results need to be confirmed in a prospective manner.
This paper references
10.1016/S1547-4127(04)00108-2
External beam radiation therapy for the treatment of pleural mesothelioma.
E. Baldini (2004)
10.1016/j.jtcvs.2014.10.128
Updated patterns of failure after multimodality therapy for malignant pleural mesothelioma.
E. Baldini (2015)
10.1007/s11864-011-0146-4
The Evolution of Multimodality Therapy for Malignant Pleural Mesothelioma
M. Zauderer (2011)
10.1016/S0090-3671(10)79654-3
Extrapleural pneumonectomy followed by intracavitary intraoperative hyperthermic cisplatin with pharmacologic cytoprotection for treatment of malignant pleural mesothelioma: A phase II prospective study
D. Jones (2010)
10.1016/j.lungcan.2013.10.013
Radical pleurectomy/decortication followed by high dose of radiation therapy for malignant pleural mesothelioma. Final results with long-term follow-up.
E. Minatel (2014)
10.1016/j.jtcvs.2013.01.039
The role of surgical cytoreduction in the treatment of malignant pleural mesothelioma: meeting summary of the International Mesothelioma Interest Group Congress, September 11-14, 2012, Boston, Mass.
V. Rusch (2013)
10.1093/ANNONC/MDU438.65
LBA37_PRNEOADJUVANT CHEMOTHERAPY AND EXTRAPLEURAL PNEUMONECTOMY (EPP) OF MALIGNANT PLEURAL MESOTHELIOMA (MPM) WITH OR WITHOUT HEMITHORACIC RADIOTHERAPY: FINAL RESULTS OF THE RANDOMIZED MULTICENTER PHASE II TRIAL SAKK17/04
R. Stahel (2014)
10.1159/000337060
Novel Intrapleural Therapies for Malignant Diseases
A. Haas (2012)
10.1007/s00259-010-1704-x
FDG PET/CT patterns of treatment failure of malignant pleural mesothelioma: relationship to histologic type, treatment algorithm, and survival
V. Gerbaudo (2010)
10.1097/JTO.0b013e31827740f0
Patterns of Failure, Toxicity, and Survival after Extrapleural Pneumonectomy and Hemithoracic Intensity-Modulated Radiation Therapy for Malignant Pleural Mesothelioma
D. Gomez (2013)
10.1186/1471-2407-13-22
Phase II trial of neoadjuvant pemetrexed plus cisplatin followed by surgery and radiation in the treatment of pleural mesothelioma
R. Federico (2012)
10.1016/j.athoracsur.2009.09.028
Second surgery for recurrence of malignant pleural mesothelioma after extrapleural pneumonectomy.
L. Politi (2010)
10.1016/j.lungcan.2013.11.026
A systematic review and meta-analysis of surgical treatments for malignant pleural mesothelioma.
C. Cao (2014)
Intracavitary Cisplatin-Fibrin Chemotherapy After Resection For Malignant Pleural Mesothelioma Patients (Influence-Meso) - Preliminary Results
I. Opitz (2013)
10.1016/j.lungcan.2011.08.011
Second-line chemotherapy in malignant pleural mesothelioma: results of a retrospective multicenter survey.
P. Zucali (2012)
10.1016/j.jtcvs.2013.07.012
Clinical indications and results after chest wall resection for recurrent mesothelioma.
B. Burt (2013)
10.1097/JTO.0b013e3181f1cf2b
Malignant Pleural Mesothelioma: A Population-Based Study of Survival
M. Milano (2010)
MO 14 . 05 Intracavitary cisplatinfi brin chemotherapy after resection for malignant pleural mesothelioma patients ( in fl uencemeso ) — preliminary results
I Opitz (2013)
10.1016/j.ejcts.2009.08.027
Prognostic significance of epithelial-mesenchymal transition in malignant pleural mesothelioma.
Alexandra Schramm (2010)
10.1016/J.THORSURG.2004.06.006
Patterns of failure following surgical resection for malignant pleural mesothelioma.
P. Jänne (2004)
10.1016/j.jtcvs.2007.10.054
Extrapleural pneumonectomy versus pleurectomy/decortication in the surgical management of malignant pleural mesothelioma: results in 663 patients.
R. Flores (2008)
10.1097/JTO.0b013e3181a5292c
Patterns of Local and Nodal Failure in Malignant Pleural Mesothelioma After Extrapleural Pneumonectomy and Photon-Electron Radiotherapy
V. Gupta (2009)
10.3978/j.issn.2072-1439.2014.05.03
Management of malignant pleural mesothelioma-The European experience.
I. Opitz (2014)
10.1097/MNM.0b013e3283653862
Patterns of disease progression on 18F-fluorodeoxyglucose positron emission tomography–computed tomography in patients with malignant pleural mesothelioma undergoing multimodality therapy with pleurectomy/decortication
A. Billè (2013)
10.1093/ANNONC/MDH059
Modified RECIST criteria for assessment of response in malignant pleural mesothelioma.
M. Byrne (2004)
10.1200/JCO.2004.10.071
Neoadjuvant chemotherapy followed by extrapleural pneumonectomy in malignant pleural mesothelioma.
W. Weder (2004)



This paper is referenced by
10.1016/j.athoracsur.2019.11.048
Clinical outcomes with recurrence after pleurectomy/decortication for malignant pleural mesothelioma.
Akifumi Nakamura (2020)
10.3390/ijms21176306
Repurposing Quinacrine for Treatment of Malignant Mesothelioma: In-Vitro Therapeutic and Mechanistic Evaluation
N. Kulkarni (2020)
10.3389/fonc.2019.00961
Stereotactic Body Radiation Therapy (SBRT) as Salvage Therapy for Oligorecurrent Pleural Mesothelioma After Multi-Modality Therapy
C. Schroeder (2019)
10.1007/s10147-017-1126-x
Post-recurrence chemotherapy for mesothelioma patients undergoing extrapleural pneumonectomy
T. Takuwa (2017)
10.3892/ijo.2018.4555
Preclinical investigation of folate receptor-targeted nanoparticles for photodynamic therapy of malignant pleural mesothelioma
T. Kato (2018)
10.1016/j.jtho.2018.02.021
Progress in the Management of Malignant Pleural Mesothelioma in 2017
Amanda J McCambridge (2018)
10.1016/j.jtho.2018.02.021
State of the Art : Advances in Malignant Pleural Mesothelioma in 2017
Amanda J McCambridge (2018)
10.1016/j.athoracsur.2018.05.087
Metachronous Lung Cancer After Pleurectomy/Decortication.
Y. Kai (2019)
10.1177/0218492316674861
Chest wall resection for mesothelioma recurrence after surgery
P. Bertoglio (2016)
10.3892/ol.2019.9979
Prolonged post-recurrence survival following pleurectomy/decortication for malignant pleural mesothelioma.
Yuichiro Kai (2019)
10.1080/17476348.2019.1678386
Approved and emerging treatments of malignant pleural mesothelioma in elderly patients
G. Ceresoli (2019)
10.1016/j.annonc.2019.12.009
Lurbinectedin as second- or third-line palliative therapy in malignant pleural mesothelioma: an international, multi-centre, single-arm, phase II trial (SAKK 17/16).
Y. Metaxas (2020)
10.1016/S1470-2045(17)30459-X
Radiotherapy for the treatment of malignant pleural mesothelioma.
M. Perrot (2017)
10.1016/j.rmed.2018.06.026
A systematic review and meta-analysis of second-line therapies for treatment of mesothelioma.
F. Petrelli (2018)
10.1016/j.lungcan.2016.07.012
Combination of cisplatin and lurbinectedin as palliative chemotherapy in progressive malignant pleural mesothelioma: Report of two cases.
Y. Metaxas (2016)
10.3857/roj.2019.00150
Preliminary results of entire pleural intensity-modulated radiotherapy in a neoadjuvant setting for resectable malignant mesothelioma
J. H. Hong (2019)
10.1016/j.jtho.2018.08.001
Surgery in Malignant Pleural Mesothelioma
R. Bueno (2018)
10.21037/shc.2018.05.06
Surgical technique of pleurectomy/decortication
Masaki Hashimoto (2018)
10.18632/oncotarget.19134
Low-dose photon irradiation induces invasiveness through the SDF-1α/CXCR4 pathway in malignant mesothelioma cells.
Y. Yamauchi (2017)
10.1016/j.cytogfr.2017.07.003
Immune checkpoint therapy of mesothelioma: Pre-clinical bases and clinical evidences.
L. Calabrò (2017)
10.1634/theoncologist.2018-0501
Systemic Therapy Use and Outcomes After Relapse from Preoperative Radiation and Extrapleural Pneumonectomy for Malignant Pleural Mesothelioma.
S. V. Soldera (2018)
Semantic Scholar Logo Some data provided by SemanticScholar