A phase II trial of prolonged, continuous infusion of low-dose gemcitabine plus cisplatin in patients with advanced malignant pleural mesothelioma

Arrieta, Óscar; López-Macías, Diego; Mendoza-García, Víctor Osvaldo; Bacon-Fonseca, Ludwing; Muñoz‐Montaño, Wendy; Macedo-Pérez, Eleazar Omar; Muñiz-Hernández, Saé; Blake-Cerda, M.; Corona-Cruz, José Francisco

doi:10.1007/s00280-014-2429-5

Cited by 28 publications

(26 citation statements)

References 41 publications

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“…Other recommended first-line combination chemotherapy options include (1) pemetrexed/carboplatin, which was assessed in 3 large phase II studies (median survival, 12.7, 14, and 14 months, respectively) and a large expanded access nonrandomized study 34,[51][52][53] ; or (2) gemcitabine/ cisplatin, which was assessed in phase II studies (median survival, 9.6-14.7 months). 35,36,40,54,55 The carboplatin/pemetrexed regimen is a better choice for patients with poor PS or comorbidities. 51 Gemcitabine/cisplatin is only recommended for patients who cannot take pemetrexed.…”

Section: Principles Of Surgerymentioning

confidence: 99%

NCCN Guidelines Insights: Malignant Pleural Mesothelioma, Version 3.2016

Ettinger¹,

Wood²,

Akerley³

et al. 2016

J Natl Compr Canc Netw

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These NCCN Guidelines Insights focus on recent updates to the NCCN Guidelines for Malignant Pleural Mesothelioma (MPM). These NCCN Guidelines Insights discuss systemic therapy regimens and surgical controversies for MPM. The NCCN panel recommends cisplatin/pemetrexed (category 1) for patients with MPM. The NCCN panel also now recommends bevacizumab/cisplatin/pemetrexed as a first-line therapy option for patients with unresectable MPM who are candidates for bevacizumab. The complete version of the NCCN Guidelines for MPM, available at NCCN.org, addresses all aspects of management for MPM including diagnosis, evaluation, staging, treatment, surveillance, and therapy for recurrence and metastasis; NCCN Guidelines are intended to assist with clinical decision-making.

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Section: Principles Of Surgerymentioning

confidence: 99%

NCCN Guidelines Insights: Malignant Pleural Mesothelioma, Version 3.2016

Ettinger¹,

Wood²,

Akerley³

et al. 2016

J Natl Compr Canc Netw

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“…The palliative effect of combination chemotherapy for patients with MPM has been documented previously . The experience from the Royal Marsden Hospital focused on the palliative benefits of mitomycin C, vinblastine and cisplatin.…”

Section: Introductionmentioning

confidence: 95%

“…The palliative effect of combination chemotherapy for patients with MPM has been documented previously. 8,9 The experience from the Royal Marsden Hospital focused on the palliative benefits of mitomycin C, vinblastine and cisplatin. That study demonstrated an objective response rate of 13.5%, with a median OS of 7 months, and 69% of patients reported some improvement of symptoms.…”

Section: Introductionmentioning

confidence: 99%

Characteristics and long‐term outcomes of advanced pleural mesothelioma in Latin America (MeSO‐CLICaP)

Rojas

Af²,

Trejo-Rosales

et al. 2019

Thoracic Cancer

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Background Malignant pleural mesothelioma (MPM) is an aggressive tumor, associated with poor prognosis. There is a lack of information about the clinical and pathological features related with survival in the Latin American population. Methods The MeSO‐CLICaP registry identified 302 patients with advanced MPM diagnosed and treated between January 2008 and March 2016. The Cox model was applied to determine the variables associated with survival. A random forest tree model was built to predict the response to first‐line chemotherapy among Latin American patients. Results The median age was 61.1 years (SD 10.6 years), 191 (63.2%) were men, 65.9% were ever smokers, and 38.7% had previous exposure to asbestos. A total of 237 (78.5%) had epithelioid tumors, and 188 (62.3%) and 114 (37.7%) cases had stage III or IV MPM, respectively. A total of 49 patients (16.2%) underwent pleurectomy, 57 (18.9%) received radiotherapy, and 279 patients received first‐line platinum‐based chemotherapy. The overall response rate to first‐line chemotherapy was 40.4%, progression‐free survival to first‐line treatment was 5.7 months (95% CI 4.9–6.5), and 63 (20.8%) patients had pemetrexed maintenance. The median overall survival was 16.8 months (95% CI 13.0–20.5), and multivariate analysis found that stage ( P = 0.013), and pleurodesis ( P = 0.048), were independent prognostic factors for first‐line overall survival. The model to predict response to first‐line chemotherapy obtained a 0.98 area under the curve, a sensitivity of 93%, and a specificity of 95% for detecting responders and non‐responders. Conclusion This study identifies factors associated with clinical benefit from chemotherapy among advanced MPM Latin American patients, emphasizing the impact of histology and the clinical benefit of chemotherapy on outcomes.

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“…3). Studies consistently show that treatment with gemcitabine/cisplatin doublet achieves comparable results67828. In Slovenian randomized phase II trial comparing pemetrexed/cisplatin and gemcitabine/cisplatin, overall median OS reached 18.6 months and there were no significant differences between groups treatment29.…”

Section: Discussionmentioning

confidence: 94%

Clinical-pharmacogenetic models for personalized cancer treatment: application to malignant mesothelioma

Goričar

Kovač

Dolžan

2017

Sci Rep

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Large interindividual differences in treatment outcome are observed in cancer patients undergoing chemotherapy. Our aim was to develop and validate clinical-pharmacogenetic prediction models of gemcitabine/cisplatin or pemetrexed/cisplatin treatment outcome and develop an algorithm for genotype-based treatment recommendations in malignant mesothelioma (MM). We genotyped 189 MM patients for polymorphisms in gemcitabine, pemetrexed and cisplatin metabolism, transport and drug target genes and DNA repair pathways. To build respective clinical-pharmacogenetic models, pharmacogenetic scores were assigned by rounding regression coefficients. Gemcitabine/cisplatin model was based on training group of 71 patients and included CRP, histological type, performance status, RRM1 rs1042927, ERCC2 rs13181, ERCC1 rs3212986, and XRCC1 rs25487. Patients with higher score had shorter progression-free (PFS) and overall survival (P < 0.001). This model’s sensitivity was 0.615 and specificity 0.812. In independent validation group of 66 patients the sensitivity and specificity were 0.667 and 0.641, respectively. Pemetrexed/cisplatin model was based on 57 patients and included CRP, MTHFD1 rs2236225, and ABCC2 rs2273697. Patients with higher score had worse response and shorter PFS (P < 0.001). This model’s sensitivity was 0.750 and specificity 0.607. In independent validation group of 20 patients the sensitivity and specificity were 0.889 and 0.500, respectively. The proposed algorithm based on these models could enable the choice of the most effective chemotherapy for 85.5% of patients and lead to improved treatment outcome in MM.

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A phase II trial of prolonged, continuous infusion of low-dose gemcitabine plus cisplatin in patients with advanced malignant pleural mesothelioma

Abstract: Low-dose, prolonged gemcitabine infusion plus cisplatin has acceptable toxicity and high efficacy with improved quality of life, representing an affordable regimen for the low-income population.

Cited by 28 publications

References 41 publications

NCCN Guidelines Insights: Malignant Pleural Mesothelioma, Version 3.2016

NCCN Guidelines Insights: Malignant Pleural Mesothelioma, Version 3.2016

Characteristics and long‐term outcomes of advanced pleural mesothelioma in Latin America (MeSO‐CLICaP)

Clinical-pharmacogenetic models for personalized cancer treatment: application to malignant mesothelioma

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