title: Divided dose of cisplatin combined with gemcitabine in malignant mesothelioma.
abstract: Malignant mesothelioma is a rare but notoriously chemoresistant tumor. An impressive activity of gemcitabine and cisplatin combination in malignant mesothelioma has been shown. However, the hematological toxicity and nephrotoxicity related to this regimen affect the patient's life negatively. The aim of this study is to investigate the efficacy and toxicity of divided dose of cisplatin combined with gemcitabine in chemo-naïve patients with malignant mesothelioma. Twenty-six eligible patients with malignant mesothelioma were enrolled onto the study. Cisplatin 35 mg/m(2) and gemcitabine 800 mg/m(2) were administered on days 1 and 8 as intravenous infusion in a 3-week cycle, up to maximum 6 cycles. Response and toxicity evaluations were performed in 26 patients. Male-female ratio was 11/15 with a mean age of 50.5 years (37-70). Locations of tumor were pleura in 16 patients, and peritoneum in 10 patients. All patients had epitheloid subtype of malignant mesothelioma. The partial response and stable disease were observed in 6 patients (23.1%) and in 13 patients (50%), respectively, with an overall tumor control rate of 73.1%. Seven patients (26.9%) had progressive disease. Median time to disease progression and survival were 4 and 19.5 months, respectively. Grade 3 nausea and vomiting were observed in one patient (3.8%), grade 4 neutropenia developed in one patient (3.8%) and grades 3-4 thrombocytopenia and nephrotoxicity did not develop. There was no treatment related death. Divided dose of cisplatin combined with gemcitabine, at the current dosage and schedule, appears to be an active regimen in chemotherapy-naïve patients with malignant mesothelioma, and well-tolerated.
authors.affiliation: Department of Medical Oncology, Ankara University School of Medicine, 06590-TR, Dikimevi, Ankara, Turkey.
authors.forename: Güngör
authors.initials: G
authors.lastname: Utkan
authors.forename: Abdullah
authors.initials: A
authors.lastname: Büyükçelik
authors.forename: Bülent
authors.initials: B
authors.lastname: Yalçin
authors.forename: Hakan
authors.initials: H
authors.lastname: Akbulut
authors.forename: Ahmet
authors.initials: A
authors.lastname: Demirkazik
authors.forename: Dilek
authors.initials: D
authors.lastname: Dinçol
authors.forename: Handan
authors.initials: H
authors.lastname: Onur
authors.forename: Deniz
authors.initials: D
authors.lastname: Gören
authors.forename: Umut
authors.initials: U
authors.lastname: Mousa
authors.forename: Filiz Cay
authors.initials: FC
authors.lastname: Senler
authors.forename: Fikri
authors.initials: F
authors.lastname: Içli
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002945:Cisplatin / Q000008:administration & dosage*; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives*; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008654:Mesothelioma / Q000188:drug therapy*; D008875:Middle Aged; D013997:Time Factors; D016896:Treatment Outcome; D000093542:Gemcitabine
chemical_list: D003841:Deoxycytidine; D002945:Cisplatin; D000093542:Gemcitabine