Second-line gemcitabine-based chemotherapy regimens improve overall 3-year survival rate in patients with malignant pleural mesothelioma: a multicenter retrospective study

Mutlu, Hasan; Gündüz, Şeyda; Karaca, Halıt; Büyükçelik, Abdullah; Cihan, Yasemin Benderli; Erden, Abdülsamet; Akca, Zeki; Çoşkun, Hasan Şenol

doi:10.1007/s12032-014-0074-9

Cited by 8 publications

(5 citation statements)

References 15 publications

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“…Generally, these results fall within the wide range reported by other authors with regard to both response rate (11-40% for response and 35-75% for SD) and PFS (9.2 months in our series and 2-8.2 months in the literature) [7][8][9][10]. The median OS of our patients was quite high (18.7 months), while it ranges between 7 and 33 months according to data from population and clinical studies [3,5,[11][12][13][14].…”

Section: Discussionsupporting

confidence: 88%

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Clinical Features and Treatment Outcome of Malignant Pleural Mesothelioma

Filiberti

Taveggia²,

Grosso

et al. 2017

Oncol Res Treat

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Background: Malignant pleural mesothelioma is a problematic condition due to poor prognosis and difficulties in management. We evaluated the treatment and outcome of 378 mesothelioma patients referred to 6 Italian Oncology Departments. Methods: Demographic and clinical data were collected. Treatment was assessed in terms of chemotherapy (line of treatment, pemetrexed-based regimen, other therapies), surgery, and radiotherapy. Response to therapy, progression-free survival, and overall survival were evaluated. Results: 36 and 342 patients received best supportive care and active treatment, respectively; 86 patients underwent surgery, and 26 received trimodal therapy. Disease control after first-line chemotherapy was achieved in 74.2% of patients (75.7% in patients treated with pemetrexed combined with other drugs and 69% with pemetrexed as monotherapy). The disease control rate was 82.6% in pemetrexed re-challenged individuals. Median survival time was 11.6 months with supportive care, 16.2 months with chemotherapy only, 32.4 months with surgery plus chemotherapy, and 47.2 months with trimodal therapy. A more favorable prognosis was observed in responders to first-line therapy who were then actively treated with second-line (24.8 vs. 11.8 months in non-responders, p < 0.001) and third-line chemotherapy (28.9 vs. 17.8 months in non-responders, p = 0.005). Conclusion: Mesothelioma patients benefited from chemotherapy alone only when retreated in the second line after response to first-line therapy.

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Section: Discussionsupporting

confidence: 88%

“…In everyday clinical practice, a second-line CT is offered at progression. Median survival varies between 10.5 and 13.6 months for re-challenge with a pemetrexed-based therapy, and between 6.2 and 20.8 months in patients treated with other CTs [11,16,18].…”

Section: Discussionmentioning

confidence: 99%

Clinical Features and Treatment Outcome of Malignant Pleural Mesothelioma

Filiberti

Taveggia²,

Grosso

et al. 2017

Oncol Res Treat

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“…In this study, the median OS for patients with gemcitabine/carboplatin was 10 months versus 16.5 months in the Favaretto Phase II study 18 . gemcitabine as monotherapy had a median OS of nine months in our study and 13.1 months in the Mutlu multicenter retrospective study 19 . For gemcitabine/cisplatin in our study, the median OS was 11 months compared to the Byrne phase II study that was 10.2 months.…”

Section: Discussioncontrasting

confidence: 42%

Prognostic factors for progression‐free and overall survival in malignant pleural mesothelioma

et al. 2021

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Background Malignant pleural mesothelioma is an infrequent neoplasia with a poor prognosis and the majority of patients already have advanced disease at the time of presentation. Exposure to asbestos is the most important risk factor for malignant pleural mesothelioma. Mesothelioma is a neoplasia with a long preclinical stage that can span from 15 to 40 years. Methods This was a descriptive, observational, retrospective study of 136 patients with a confirmed diagnosis of mesothelioma, which compared histological subtypes, immunohistochemical biomarkers, concomitant chronic degenerative diseases, tobacco use, age at the time of diagnosis, clinical stage and chemotherapy agents used or other treatments such as radiotherapy and surgery to identify all the factors that impact in the prognosis of overall survival (OS) and progression‐free survival (PFS). Results A total of 136 patients were included in the study. In the total study population, 84 patients were male (61.8%) and 52 were female (38.2%). Median PFS was nine months (95% confidence interval [CI]: 8.4–9.5 months) and median OS was 12 months (95% CI: 11.3–12.6). The results indicated that the most determining prognostic factors for OS and PFS were cell differentiation measured by immunohistochemical biomarkers, the treatment chosen, and that RECIST was the most significant in the evaluation of patient response to treatment. Conclusions Malignant pleural mesothelioma is a cancer with a poor prognosis usually diagnosed at an advanced stage of disease. Our study revealed that the prognostic factors for OS and PS were cell differentiation, the treatment chosen and RECIST.

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“…Finally, a total of 29 citations were considered eligible for the systematic review. This included 3 Phase III studies [10][11][12], 18 Phase II studies [13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30] and 8 retrospective studies [31][32][33][34][35][36][37][38]. Twenty-eight studies among these were dealing with second-line setting, while one study dealt with third-line settings.…”

Section: Selection Of Studiesmentioning

confidence: 99%

Systemic therapy options for malignant pleural mesothelioma beyond first-line therapy: a systematic review

Abdel‐Rahman¹,

Kelany

2015

Expert Review of Respiratory Medicine

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The aim of this systematic review is to assess the evidence for the available 2nd/3rd line systemic therapies for malignant pleural mesothelioma (MPM). Eligible studies were obtained through appropriate databases and meetings abstracts search. A total of 29 studies were considered eligible for this review and it includes three Phase III studies, eighteen phase II studies and eight retrospective studies. For the Phase III studies, none have achieved an overall survival benefit; while for the Phase II studies, the majority have not achieved sufficient satisfactory outcome to justify advancement to Phase III studies. We believe that the best salvage treatment for MPM would be inclusion into appropriately designed clinical trials. In the absence of a clinical trial, gemcitabine and/or vinorelbine-based regimens could be considered. Moreover, pemetrexed re-challenge can be considered in selected pemetrexed-sensitive patients.

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Second-line gemcitabine-based chemotherapy regimens improve overall 3-year survival rate in patients with malignant pleural mesothelioma: a multicenter retrospective study

Cited by 8 publications

References 15 publications

Clinical Features and Treatment Outcome of Malignant Pleural Mesothelioma

Clinical Features and Treatment Outcome of Malignant Pleural Mesothelioma

Prognostic factors for progression‐free and overall survival in malignant pleural mesothelioma

Systemic therapy options for malignant pleural mesothelioma beyond first-line therapy: a systematic review

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