Weekly high-dose cisplatin in malignant pleural mesothelioma.
BACKGROUND
Cisplatin at conventional doses has marginal activity in mesothelioma. A dose-response relation for cisplatin has been suggested in other tumor types. In a phase I study on weekly cisplatin administration, 3 of 5 patients with mesothelioma responded. Therefore, a phase II study with weekly cisplatin was started with the recommended dose of 80 mg/m2/week for six weeks.


METHODS
Fourteen patients with mesothelioma stage II, with measurable lesions, were treated with cisplatin at a dose of 80 mg/m2 weekly for six weeks. Cisplatin was administered in 3% NaCl and combined with ondansetron as antiemetic.


RESULTS
Five patients had partial responses (response rate 36%; 95% confidence interval 12%-65%) lasting 2-8 months. Seven patients had stable disease. Ototoxicity, grade 2 in 3 patients and grade 3 in 2, was the most troublesome side effect.


CONCLUSIONS
Cisplatin given at a higher dose intensity than in conventional schedules is active in mesothelioma. The response duration is short, however, possibly due to lack of effective maintenance therapy.
Planting
A S
AS
Department of Medical Oncology, Rotterdam Cancer Institute/Dr. Daniel den Hoed Kliniek, The Netherlands.
Schellens
J H
JH
Goey
S H
SH
van der Burg
M E
ME
de Boer-Dennert
M
M
Stoter
G
G
Verweij
J
J
D000328:Adult; D000368:Aged; D002945:Cisplatin / Q000008:administration & dosage* / Q000009:adverse effects; D004334:Drug Administration Schedule; D006801:Humans; D008297:Male; D008654:Mesothelioma / Q000188:drug therapy*; D008875:Middle Aged; D010997:Pleural Neoplasms / Q000188:drug therapy*
D002945:Cisplatin