Malignant peritoneal mesothelioma—Results from the International Expanded Access Program using pemetrexed alone or in combination with a platinum agent

Cartenì, Giacomo; Manegold, Christian; García, Germán Martín; Siena, Salvatore; Zielinski, Christoph; Amadori, Dino; Liu, Y.; Blatter, J.; Visseren‐Grul, Carla; Stahel, Rolf A.

doi:10.1016/j.lungcan.2008.08.013

Cited by 117 publications

(104 citation statements)

References 29 publications

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“…Our median survival of 3.9 months is evidently lower than the 5.6 months reported for Italy [21], but difficult to compare because 41% of cases were female in the Italian study. Response rates to antifolate-platinum treatment are similar to those for pleural lesions [22]. Cytoreductive surgery followed by hyperthermic intraperitoneal chemotherapy might be a promising treatment alternative given the 47% 5-yr survival reported by YAN et al [23], albeit in selected patients with a mean age of 50 yrs.…”

Section: Discussionmentioning

confidence: 69%

Population-based survival for malignant mesothelioma after introduction of novel chemotherapy

Damhuis¹,

Schroten²,

Burgers³

2011

Eur Respir J

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Malignant mesothelioma is known for its dismal prognosis and poor response to conventional treatment. Chemotherapy with cisplatin-antifolate combinations recently showed promising response rates and prolonged survival in randomised trials.To assess the impact of this development on clinical practice and survival at a population-based level, treatment patterns and survival trends were studied for patients diagnosed with mesothelioma in the period 1995-2006. 4,731 records were retrieved from the Netherlands Cancer Registry and chemotherapy use and median survival were analysed.For the periods 1995-1998 to 2005-2006, chemotherapy use increased from 8% to 36%. Median survival increased over time from 7.1 months to 9.2 months. For pleural mesothelioma, multivariable analysis demonstrated that survival was poorer for elderly patients and sarcomatoid tumours. The prognostic impact of chemotherapy increased with time. Median survival for chemotherapy treated patients improved from 10.1 months (1995-1998) to 13.1 months (2005)(2006). For peritoneal mesothelioma, median survival was poor (3.9 months) but better for females and younger patients.This study demonstrates that chemotherapy use increased at a national level and coincided with an improvement in survival. The novel chemotherapy regimen appears to be more effective but, due to the observational nature of this study, alternative explanations cannot be excluded.

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Section: Discussionmentioning

confidence: 69%

Population-based survival for malignant mesothelioma after introduction of novel chemotherapy

Damhuis¹,

Schroten²,

Burgers³

2011

Eur Respir J

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“…Thus, the efficacy of pemetrexed/cisplatin combination therapy in patients failing HIPEC is currently unknown. In addition, in EAPs, most pretreated patients were given pemetrexed monotherapy rather than the combination [9,23]. Retrospective series or case reports like the present one remain the only source of information on the management of patients with this rare disease.…”

Section: Discussion and Review Of The Literaturementioning

confidence: 90%

“…As mentioned above, pemetrexed is registered for the treatment of malignant pleural mesothelioma [11], and the activity of this anticancer drug in mesothelioma of other primary locations is supported mostly by retrospective data [9,[19][20][21]. The expanded access program (EAP) for pemetrexed that included 113 patients with peritoneal mesothelioma and indicated the efficacy of pemetrexed alone or in combination with cisplatin or carboplatin in the treatment of malignant peritoneal mesothelioma has been reported [9].…”

Section: Discussion and Review Of The Literaturementioning

confidence: 99%

“…Palliative systemic intravenous chemotherapy remains the only option, but this tumor is, in general, considered chemoresistant. As there is no chemotherapeutic agent that has demonstrated a consistent survival advantage in peritoneal mesothelioma, either alone or in combination, and due to inadequate number of patients who could be enrolled in prospective trials, there currently exists no approved treatment for peritoneal mesothelioma and the therapeutic strategy generally follows guidelines for pleural mesothelioma [9]. There is no generally accepted strategy for patients failing HIPEC.…”

Section: Introductionmentioning

confidence: 99%

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Prolonged response to pemetrexed-based chemotherapy in a patient with peritoneal mesothelioma: a case report and review of the literature

et al. 2016

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AbstractPeritoneal mesothelioma is a rare tumor typically presenting with ascites and associated with occupational asbestos exposure with a latency period of 20–40 years. Intensive multi-modality approach combining cytoreductive surgery, intraperitoneal chemotherapy and possibly radiotherapy can be considered, but otherwise the prognosis is rather poor. Palliative chemotherapy may be an option in these rare cases. However, no approved systemic treatment exists for peritoneal mesothelioma. We present here a patient with peritoneal mesothelioma who was treated with the combination of pemetrexed with cisplatin shortly after the failure of hyperthermic intraperitoneal chemotherapy. The patient experienced durable partial response to the treatment, resolution of ascites, and returned to his normal daily life activities. With the exception of palliative chemotherapy in case of patients in good condition, therapeutic options in patients with peritoneal mesothelioma are currently very limited. The combination of pemetrexed and cisplatin can lead to long-term control in selected patients.

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“…Historically, patients treated with palliative surgery with or without chemotherapy experienced a median os of approximately 1 year 35,36 . With novel systemic chemotherapy regimens consisting of a combination of pemetrexed and platinum compounds or gemcitabine, the median os has reached 8.7-26.7months 37,38 . The implementation of crs and hipec has further improved survival.…”

Section: Malignant Peritoneal Mesotheliomamentioning

confidence: 99%

Treatment of Peritoneal Surface Malignancies with Hyperthermic Intraperitoneal Chemotherapy—Current Perspectives

2016

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Peritoneal carcinomatosis (ptc) represents advanced malignant disease and has generally been associated with a grim prognosis. Peritoneal surface malignancy is often the major source of morbidity and mortality; it is of major concern in cancer management. Although ptc is categorized as metastatic disease, it represents a special disease pattern considered to be a locoregional disease limited to the abdominal cavity. The combination of cytoreductive surgery (crs) and intraoperative hyperthermic intraperitoneal chemotherapy (hipec) has successfully been used as locoregional treatment for selected patients with ptc from gastric, colorectal, and ovarian cancer; with mesothelioma; and with pseudomyxoma peritonei. In the prophylactic setting, hipec can also be used to prevent ptc in high-risk patients, and the first results of the "second-look" approach are promising. Patient selection-in which the risks of perioperative morbidity and mortality, which are analogous to those for any other major gastrointestinal surgery, are assessed-is of utmost importance. Those risks have to be weighed against the anticipated survival benefit, which depends mainly on tumour biology, extent of disease, and probability of achieving complete crs. The present review discusses the principles of crs and hipec, the most significant recent clinical data, and current perspectives concerning the application of this treatment modality in various malignancies. Ongoing trials and future directions are noted. It appears that the combination of crs and hipec is an indispensable tool in the oncologist's armamentarium.

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Malignant peritoneal mesothelioma—Results from the International Expanded Access Program using pemetrexed alone or in combination with a platinum agent

Cited by 117 publications

References 29 publications

Population-based survival for malignant mesothelioma after introduction of novel chemotherapy

Population-based survival for malignant mesothelioma after introduction of novel chemotherapy

Prolonged response to pemetrexed-based chemotherapy in a patient with peritoneal mesothelioma: a case report and review of the literature

Treatment of Peritoneal Surface Malignancies with Hyperthermic Intraperitoneal Chemotherapy—Current Perspectives

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