Second-line (post-study) chemotherapy received by patients treated in the phase III trial of pemetrexed plus cisplatin versus cisplatin alone in malignant pleural mesothelioma

Manegold, Christian; Symanowski, James T.; Gatzemeier, U.; Reck, Martin; Pawel, Joachim von; Kortsik, C.; Nackaerts, Kristiaan; Lianes, P.; Vogelzang, Nicholas J.

doi:10.1093/annonc/mdi187

Cited by 147 publications

(79 citation statements)

References 17 publications

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“…Immortal time bias [16] poses another problem in nonrandomised studies as survival is calculated from day of diagnosis and, by definition, chemotherapy patients cannot die between diagnosis and their first cycle, hence getting a survival head start. The latter bias may also explain why survival appears to be better for patients who receive post-study chemotherapy [17].…”

Section: Discussionmentioning

confidence: 99%

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: 99%

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

Damhuis¹,

Schroten²,

Burgers³

2011

Eur Respir J

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“…Transl Lung Cancer Res 2017;6(3):295-314 tlcr.amegroups.com chemotherapy had a statistically prolonged survival with an adjusted hazard ratio of 0.56 (CI: 0.44-0.72), demonstrating benefit of additional systemic therapy after first line treatment (65). Prior to cisplatin and pemetrexed becoming the first-line standard of care, Jassem et al showed that pemetrexed increased progression free survival in previously treated, pemetrexed-naïve patients (66).…”

Section: Nd Line and Salvage Therapymentioning

confidence: 98%

Novel systemic therapy against malignant pleural mesothelioma

Mancuso

Neal

2017

Transl. Lung Cancer Res.

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Malignant pleural mesothelioma is an aggressive tumor of the pleura with an overall poor prognosis. Even with surgical resection, for which only a subset of patients are eligible, long term disease free survival is rare. Standard first-line systemic treatment consists of a platinum analog, an anti-metabolite, and sometimes anti-angiogenic therapy, but there is currently no well-established standard therapy for refractory or relapsed disease. This review focuses on efforts to develop improved systemic therapy for the treatment of malignant pleural mesothelioma (MPM) including cytotoxic systemic therapy, a variety of tyrosine kinase inhibitors and their downstream effector pathways, pharmacologic targeting of the epigenome, novel approaches to target proteins expressed on mesothelioma cells (such as mesothelin), arginine depletion therapy, and the emerging role of immunotherapy. Overall, these studies demonstrate the challenges of improving systemic therapy for MPM and highlight the need to develop therapeutic strategies to control this disease.

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“…Indirect data extracted from the follow-up of a first-line randomised trial [64] suggested that second-line chemotherapy after cisplatin-pemetrexed could increase survival in comparison with symptomatic treatment alone. These data need confirmation in a randomised study.…”

Section: Chemotherapy Of Mpmmentioning

confidence: 99%

Guidelines of the European Respiratory Society and the European Society of Thoracic Surgeons for the management of malignant pleural mesothelioma

Scherpereel¹,

Astoul²,

Baas³

et al. 2009

Eur Respir J

548

504

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Malignant pleural mesothelioma (MPM) is a rare tumour but with increasing incidence and a poor prognosis. In 2008, the European Respiratory Society/European Society of Thoracic Surgeons Task Force brought together experts to propose practical and up-to-dated guidelines on the management of MPM.To obtain an earlier and reliable diagnosis of MPM, the experts recommend performing thoracoscopy, except in cases of pre-operative contraindication or pleural symphysis. The standard staining procedures are insufficient in ,10% of cases. Therefore, we propose using specific immunohistochemistry markers on pleural biopsies. In the absence of a uniform, robust and validated staging system, we advice use of the most recent TNM based classification, and propose a three step pre-treatment assessment. Patient's performance status and histological subtype are currently the only prognostic factors of clinical importance in the management of MPM. Other potential parameters should be recorded at baseline and reported in clinical trials. MPM exhibits a high resistance to chemotherapy and only a few patients are candidates for radical surgery. New therapies and strategies have been reviewed.Because of limited data on the best combination treatment, we emphasise that patients who are considered candidates for a multimodal approach should be included in a prospective trial at a specialised centre.

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Second-line (post-study) chemotherapy received by patients treated in the phase III trial of pemetrexed plus cisplatin versus cisplatin alone in malignant pleural mesothelioma

Cited by 147 publications

References 17 publications

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

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

Novel systemic therapy against malignant pleural mesothelioma

Guidelines of the European Respiratory Society and the European Society of Thoracic Surgeons for the management of malignant pleural mesothelioma

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