Ifosfamide, carboplatin and etoposide combined with 41.8 degrees C whole body hyperthermia for malignant pleural mesothelioma.
We performed a phase II study combining 41.8 degrees C whole body hyperthermia with ICE chemotherapy, i.e. ifosfamide (5 g/m(2)), carboplatin (300 mg/m(2)) and etoposide (150 mg/m(2) on days 2 and 3), administered every 4 weeks, for patients with malignant pleural mesothelioma. Of 27 chemonäive, non-metastatic patients enrolled, 25 patients were evaluable for response. Overall response rate was 20% (five partial remissions; 95% CI 8.9-39.1%). Median survival time from the start of treatment for all patients was 76.6 weeks (95% CI 65.4-87.8 weeks). Progression free survival for all patients measured 29.6 weeks (95% CI 24.4-34.7 weeks). One year overall survival was 68% and 2 year overall survival was 20%. Major treatment toxicities included grade 3/4 neutropenia and thrombocytopenia in 74 and 33% of treatment cycles, respectively. One patient died due to sepsis. These promising results are consistent with continued clinical investigation; a phase III clinical trial with whole body hyperthermia as the independent variable has been initiated.
Bakhshandeh
A
A
Medical University of Lübeck, Ratzeburger Allee 160, 23538, Luebeck, Germany. bakhshan@medinf.mu-luebeck.de
Bruns
I
I
Traynor
A
A
Robins
H I
HI
Eberhardt
K
K
Demedts
A
A
Kaukel
E
E
Koschel
G
G
Gatzemeier
U
U
Kohlmann
Th
T
Dalhoff
K
K
Ehlers
E M
EM
Gruber
Y
Y
Zumschlinge
R
R
Hegewisch-Becker
S
S
Peters
S O
SO
Wiedemann
G J
GJ
D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D016190:Carboplatin; D003131:Combined Modality Therapy; D003907:Dexamethasone; D018572:Disease-Free Survival; D005047:Etoposide; D005260:Female; D006801:Humans; D006979:Hyperthermia, Induced; D007069:Ifosfamide; D007262:Infusions, Intravenous; D008297:Male; D008654:Mesothelioma / Q000188:drug therapy* / Q000473:pathology / Q000628:therapy*; D008875:Middle Aged; D010997:Pleural Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000628:therapy*; D018805:Sepsis / Q000139:chemically induced; D016896:Treatment Outcome
D005047:Etoposide; D003907:Dexamethasone; D016190:Carboplatin; D007069:Ifosfamide