Platinum-based doublet chemotherapy in pre-treated malignant pleural mesothelioma (MPM) patients: a mono-institutional experience.

摘要: Abstract Background The major clinical problems of MPM management are the short duration response and early relapse. Currently, after first-line standard pemetrexed/platinum combination there is not a defined regimen for second line treatment MPM, benefits in fit patients uncertain. We analyzed feasibility gemcitabine/platinum chemotherapy pretreated patients. Methods Eligible should have relapsed with pemetrexed plus cisplatin (24%) or carboplatin (76%); 53% had previously received trimodality treatment, 18% neoadjuvant followed by pleurectomy/decortication, 29% were inoperable. Patients to PS=0–2, adequate organ function, measurable disease. Chemotherapy was gemcitabine 1000mg/m 2 days 1, 8 associated alternative platinum compound respect 1st line, i.e. 75mg/m AUC 5 day 1 every 3 weeks, 3–6 cycles. Baseline staging reassessment cycles 6 performed CT-scan. Results Since 2006 17 referred our centre. 12 males females; median age: 61 years (range 47–74); histology: epithelial, 4 sarcomatoid biphasic. PS 1–2 (15:2). carboplatin/cisplatin administered as 13 (76%) patients, third Two lost follow-up without re-evaluation, therefore radiologic assessable 15 (88%) Among evaluable 10 (67%) showed stable disease (33%) progressive Symptoms improved (53%) cases. In intent-to-treat population survival 28 weeks 13–168) time-to-treatment failure 3–75). Toxicity profile (13%) grade (40%) thrombocytopenia, (27%) leucopenia, (20%) anaemia neutropenia. Grade non haematological toxicities nausea (14%) asthenia (21%). Conclusion Gemcitabine-platinum regimens able control symptoms progression modest toxicity profile. present results from small series be confirmed prospective trial larger cohort