title: A phase II study evaluating the cisplatin and epirubicin combination in patients with unresectable malignant pleural mesothelioma.
abstract: Few chemotherapeutic agents have demonstrated their efficacy in malignant mesothelioma. The cisplatin plus doxorubicin combination has one of the highest response rates. Epirubicin is an anthracyclin, analogous to doxorubicin, with a different toxicologic pattern. As there are no data on the activity of the combination cisplatin plus epirubicin in malignant mesothelioma, the European Lung Cancer Working Party (ELCWP) designed a phase II study with response rate as primary objective. Sixty-nine eligible patients with malignant pleural mesothelioma were centrally registered. The majority of the patients were male (n=59), had a Karnofsky performance status of 80 or more (n=62) and presented with an epithelial histologic subtype (n=43). Median age was 62 years. In nine patients, metastases were documented at the initial work-up, mainly in bone, lung and skin. Three hundred and twenty-four cycles of chemotherapy were administered. The main toxicities were nausea and vomiting, neutropenia and alopecia. Among 63 assessable patients, response rate was 19.0% (95% confidence interval [CI] 9-29%). Median survival was 13.3 months. In multivariate analysis, poor prognostic factors for survival were neutrophil count and CALGB groups 4-6. In conclusion, cisplatin plus epirubicin appears as an effective regimen in malignant mesothelioma, with a favourable toxicity profile. However, it does not demonstrate superior activity to other active regimens in this disease.
authors: Department of Intensive Care and Thoracic Oncology, Institut Jules Bordet, Rue Héger-Bordet 1, 1000 Bruxelles, Belgium. thierry.berghmans@bordet.be
authors: T
authors: T
authors: Berghmans
authors: J J
authors: JJ
authors: Lafitte
authors: M
authors: M
authors: Paesmans
authors: B
authors: B
authors: Stach
authors: M C
authors: MC
authors: Berchier
authors: P
authors: P
authors: Wackenier
authors: J
authors: J
authors: Lecomte
authors: T
authors: T
authors: Collon
authors: P
authors: P
authors: Mommen
authors: J P
authors: JP
authors: Sculier
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D002945:Cisplatin / Q000008:administration & dosage; D015251:Epirubicin / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008654:Mesothelioma / Q000188:drug therapy* / Q000473:pathology; D008875:Middle Aged; D010997:Pleural Neoplasms / Q000188:drug therapy* / Q000473:pathology; D011379:Prognosis; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D015251:Epirubicin; D002945:Cisplatin