Maintenance chemotherapy with pemetrexed in patients with malignant pleural mesothelioma – case series and review of the literature

Abstract

Malignant pleural mesothelioma is a rare neoplasm with poor prognosis. Surgical complete resection, which is the only radical therapy available, is only possible in a minority of patients who suffer from a locally advanced disease. Radiotherapy can be considered as an adjuvant therapy after surgery or as supportive treatment in palliative care. Attempts are also made at combining it with chemotherapy. In cases of locally advanced, non-resectable or metastatic disease, chemotherapy remains the treatment of choice. The most effective palliative chemotherapy is the pemetrexed plus cisplatin regimen. We describe 3 cases of patients who underwent standard palliative chemotherapy with pemetrexed and cisplatin, manifesting good radiological and clinical response, followed by maintenance therapy with pemetrexed. The use of pemetrexed maintenance therapy helped achieve many years of disease control with acceptable toxicity. The consecutive stages of therapy were continuously discussed with our patients, and their informed consent was obtained. Pemetrexed maintenance therapy is not a standard procedure, but recent findings suggest it may be an efficacious option to consider in selected groups of patients. Further randomized prospective studies are needed, but a limiting factor is the rarity of the disease.

New Water-Soluble Copper(II) Complexes with Morpholine–Thiosemicarbazone Hybrids: Insights into the Anticancer and Antibacterial Mode of Action

“…3 However, recent clinical evidence demonstrated that benefits of antibiotic prophylaxis of cancer patients outweighed its risks. 4 The simultaneous suppression of pathogenic microorganisms during anticancer chemotherapy could not only interrupt or abolish tumor growth but also eventually protect cancer patients from infection. Hence, the development of novel drugs which exhibit dual anticancer and antibacterial properties in comparable concentration range would affect the malignant process and simultaneously decrease the risk of patients’ death due to infection, febrile neutropenia, and bacteraemia.…”

Synthesis, Structure, and Biologic Activity of Some Copper, Nickel, Cobalt, and Zinc Complexes with 2‐Formylpyridine N4‐Allylthiosemicarbazone

“…Despite the fact that the role of the virus and bacteria in the development of cancer is underestimated, antimicrobial prophylaxis during cancer therapy is important for reducing some side effects and the risk of death due to infection [ 55 , 56 ].…”

Synthesis, characterization, and biological activity of novel 3d metal coordination compounds with 2‐acetylpyridine N4‐allyl‐S‐methylisothiosemicarbazone

“…[ 49 ] Their administration can decrease some side effects and the risk of patients' death due to infection. [ 50 ] Consequently, substances that simultaneously exhibit both anticancer and antimicrobial activity in a similar range of concentrations are of interest. Previously, it was found that among all 3 d metal coordination compounds with thiosemicarbazones and isothiosemicarbazones, copper(II) shows the highest antibacterial and antifungal activities.…”