title: Ifosfamide, mesna, and interferon-alpha2A combination chemoimmunotherapy in malignant mesothelioma: results of a single center in central anatolia.
abstract: Our aim was to determine the efficacy of ifosfamide, mesna, and interferon alpha combination therapy in malignant mesothelioma (MM) patients. Fourty-two patients (39 evaluable) with histologically proven MM were enrolled into this study from January 1999 to October 2002. The drug schedule consisted of a combination of ifosfamide, 3000 mg/m2 1-3 d intravenous infusion (iv), the uroprotective agent mesna, 3000 mg/m2 1-3 d iv every 3 wk, and interferon alpha2a, 4.5 MU subcutaneously (sc) 3 d/wk for 6 mo as first-line chemotherapy. Overall, 140 cycles were administered to the 39 patients (median, 3.5 cycles; range, 1 to 6 cycles). Among the 39 patients, 8 partial remissions (PR) (21%) were observed. Thirteen patients (33%) had stable disease for at least 8 wk and 18 (46%) had progressive disease. Overall survival (OAS) and progression free survival (PFS) for all patients were 10.0 +/- 2.9 mo (95%CI 4.3-15.7) and 5.0 +/- 1.9 mo (95%CI 1.38-8.62), respectively. One and two year survival rates were calculated as 39% and 5%, respectively. All of the PR patients had the epithelial type of MM. Their survival time was 21.0 +/- 5.7 mo (95% CI 9.9-32.1) and significantly longer than that of nonresponders (p=0.0061). The toxicity of the drug combination was mild and well tolerated. There were no treatment-related deaths. Grade 3-4 neutropenia and febrile neutropenia were seen in 10 patients (26%) and 3 patients (8%), respectively. Chemotherapy was stopped in three patients because of renal function deficiency. One of these patients who had peritoneal MM required hemodialysis. In conclusion, this combination therapy showed encouraging antitumor activity with modest toxicity.
authors.affiliation: Medical Oncology, Erciyes University Medical Faculty, Kayseri, Turkey. altinbas@erciyes.edu.tr
authors.forename: Mustafa
authors.initials: M
authors.lastname: Altinbas
authors.forename: Ozlem
authors.initials: O
authors.lastname: Er
authors.forename: Metin
authors.initials: M
authors.lastname: Ozkan
authors.forename: Hasan Senol
authors.initials: HS
authors.lastname: Coskun
authors.forename: Inci
authors.initials: I
authors.lastname: Gulmez
authors.forename: Eyup
authors.initials: E
authors.lastname: Ekici
authors.forename: Bunyamin
authors.initials: B
authors.lastname: Kaplan
authors.forename: Bulent
authors.initials: B
authors.lastname: Eser
authors.forename: Mustafa
authors.initials: M
authors.lastname: Ozesmi
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D018450:Disease Progression; D005260:Female; D006801:Humans; D007069:Ifosfamide / Q000008:administration & dosage; D007262:Infusions, Intravenous; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000008:administration & dosage; D008297:Male; D015080:Mesna / Q000008:administration & dosage; D008654:Mesothelioma / Q000188:drug therapy* / Q000473:pathology; D008875:Middle Aged; D009503:Neutropenia / Q000139:chemically induced; D011994:Recombinant Proteins; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D015080:Mesna; D007069:Ifosfamide