|
Mesothelioma
Treatment
Articles
and Abstracts
Results
of a phase II trial of combined
chemotherapy for patients with diffuse
malignant mesothelioma of the
pleura.
Cancer
1999 Apr 15;85(8):1740-9
Kasseyet
S, Astoul P, Boutin C
Department
of Pulmonology, University Hospital la
Conception, Mediterranean University
Medical School, Marseille, France.
BACKGROUND;
Malignant pleural mesothelioma is
associated with a poor prognosis because
of its resistance to treatment. The
authors conducted a Phase II trial in
which two drugs (etoposide and
5-fluorouracil) were added to the Cancer
and Leukemia Group B cisplatin-mitomycin
regimen in an effort to define a more
effective chemotherapy.
METHODS:
Forty-five patients with confirmed Stage
II malignant pleural mesothelioma were
prospectively enrolled in the study.
Thirty-one patients received cisplatin 60
mg/m2 on Day 1, 5-fluorouracil 600 mg on
Days 1-4, folinic acid 100 mg/m2 on Days
1-4, mitomycin C 10 mg/m2 on Day 3, and
etoposide 100 mg/m2 i.v. on Days 1-3, with
prophylactic hematopoietic growth factors.
Fourteen patients received cisplatin,
5-fluorouracil, folinic acid, and
mitomycin C with the protocol unchanged,
and oral etoposide 50 mg on Days 1-21
without growth factors (1 cycle every 28
days). Histology included epithelial (in
33 cases), sacromatous (in 6), mixed (in
3), and unspecified type (in 3).
RESULTS:
Two hundred eleven cycles were
administered. Treatment was well tolerated
and the major toxicity was hematologic:
anemia in 30% of cases, neutropenia in
24%, and 2 probable cases of
mitomycin-induced pneumonitis. The
objective response rate was 38% (17 of 45
were partial responses), and the median
response duration was 12 months. The
median survival time was 16 months. There
were no differences in response or
survival between the 31 patients treated
with growth factors and the 14 patients
treated without them. Survival was
slightly better for responders than for
nonresponders who had stable disease or
progression (20 vs. 10 months,
P<0.05).
CONCLUSIONS:
This four-drug combination was effective,
with a notably high response rate,
acceptable toxicity, and good adherence to
protocol doses. The impact on survival was
limited.
PMID:
10223568, UI: 99238079
Click here to order or save
article
If
you have any questions regarding treatment
options or your legal rights, please
contact
us.
|