Cisplatin, mitomycin, and interferon-alpha2a combination chemoimmunotherapy in the treatment of diffuse malignant pleural mesothelioma.
OBJECTIVE
To investigate the therapeutic activity and toxicity of combination chemoimmunotherapy with cisplatin, mitomycin, and interferon (IFN)-alpha2a, by comparing the responses in a group of patients with diffuse malignant pleural mesothelioma (DMPM) to the responses in a control group of DMPM patients given supportive care alone.


METHODS
Patients with histopathologically confirmed DMPM were evaluated for treatment with chemoimmunotherapy.


METHODS
After the initial evaluation, all patients received either chemoimmunotherapy or supportive care from the Osmangazi University Medical Faculty, Department of Chest Diseases.


METHODS
Forty-three patients with DMPM received chemoimmunotherapy until the end of the survey; 19 patients were given supportive therapy alone after refusing chemoimmunotherapy.


METHODS
Drugs were administered according to the following schedule: IV cisplatin, 30 mg/m2 qd on days 1 and 2; IV mitomycin, 8 mg/m2 on day 1; and subcutaneous IFN-alpha2a, 4.5 million IU twice weekly. The courses were repeated every 4 weeks.


RESULTS
Overall, 232 chemoimmunotherapy cycles were administered. A total of 10 objective responses (ORs) in 43 patients (23%) were assessed, including 2 complete responses (5%), 4 partial responses, and 4 regressions. Seventeen patients had stable disease, and 16 patients had progression. The median survival time was 11.5 months for the 43 patients who received chemoimmunotherapy and 7.0 months for the 19 patients who received supportive therapy alone. The difference in survival times between the chemoimmunotherapy and supportive therapy groups was not significant. However, the median survival time for the patients who had OR was 21.3 months, which is significantly longer than that of the patients who received supportive care alone and that of patients with progressive disease (6 months). The toxicities associated with the treatment schedule of this study were, for the most part, tolerable.


CONCLUSIONS
The drug combination used in this study is moderately effective and well tolerated in patients with DMPM, especially in those who responded to the treatment.
Metintas
M
M
Department of Chest Diseases, Osmangazi University Medical Faculty, Eskisehir, Turkey. metintas@ada.net.tr
Ozdemir
N
N
Uçgun
I
I
Elbek
O
O
Kolsuz
M
M
Mutlu
S
S
Metintas
S
S
D000328:Adult; D000368:Aged; D000903:Antibiotics, Antineoplastic / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002945:Cisplatin / Q000627:therapeutic use*; D018450:Disease Progression; D005260:Female; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000627:therapeutic use*; D008297:Male; D008654:Mesothelioma / Q000188:drug therapy* / Q000401:mortality; D008875:Middle Aged; D008937:Mitomycins / Q000627:therapeutic use*; D010997:Pleural Neoplasms / Q000188:drug therapy* / Q000401:mortality; D011994:Recombinant Proteins; D015996:Survival Rate; D016896:Treatment Outcome
D000903:Antibiotics, Antineoplastic; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D008937:Mitomycins; D011994:Recombinant Proteins; D002945:Cisplatin