Efficacy and safety of first- or second-line irinotecan, cisplatin, and mitomycin in mesothelioma.
BACKGROUND
Malignant pleural mesothelioma (MPM) is a rapidly progressive lethal tumor. Treatment options remain limited and the outcome in recurrent disease is poor.


METHODS
A Phase II open-label noncomparative study was conducted to assess the safety and efficacy of the triplet combination irinotecan, cisplatin, and mitomycin-C (IPM) chemotherapy in untreated patients and in those with previous exposure to chemotherapy.


RESULTS
In 62 patients an objective response rate of 25% was observed. In the first-line setting progression-free survival measured 6.4 months (95% confidence interval [CI]: 4.5-7.3) and overall survival was 10.8 months (95% CI: 7.9-13.7). In the second-line setting progression-free survival was 7.3 months (95% CI: 3.4-11.2) and overall survival was also 7.3 months (95% CI: 4.8-9.8). Psychosocial well-being improved during chemotherapy and the main toxicity observed was neutropenia (40%).


CONCLUSIONS
IPM appeared to have a reasonable response rate with an acceptable toxicity profile in the first- and second-line treatment of MPM.
Fennell
Dean A
DA
Lung and Mesothelioma Unit, Department of Medical Oncology, St Bartholomew's Hospital, West Smithfield, London, UK.
Steele
Jeremy P C
JP
Shamash
Jonathan
J
Evans
Marie T
MT
Wells
Paula
P
Sheaff
Michael T
MT
Rudd
Robin M
RM
Stebbing
Justin
J
D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use* / Q000633:toxicity; D002166:Camptothecin / Q000008:administration & dosage / Q000031:analogs & derivatives; D002945:Cisplatin / Q000008:administration & dosage; D017322:Clinical Trials, Phase II as Topic; D005260:Female; D006801:Humans; D000077146:Irinotecan; D008297:Male; D008654:Mesothelioma / Q000188:drug therapy* / Q000401:mortality; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage; D010997:Pleural Neoplasms / Q000188:drug therapy*; D011788:Quality of Life; D015996:Survival Rate; D016896:Treatment Outcome
D016685:Mitomycin; D000077146:Irinotecan; D002945:Cisplatin; D002166:Camptothecin