title: Carboplatin plus pemetrexed as first-line treatment of patients with malignant pleural mesothelioma: a phase II study.
abstract: BACKGROUND
  Malignant pleural mesothelioma (MPM) is a rapidly progressive tumor that is increasing in frequency worldwide. Treatment options are limited, and response to chemotherapy is poor. The aim of this phase II study was to evaluate the activity of the carboplatin/pemetrexed combination as first-line chemotherapy in patients with unresectable MPM.
  
  
  METHODS
  Chemotherapy-naive patients with histologically confirmed MPM and an Eastern Cooperative Oncology Group performance status of 0-2 were enrolled. Treatment consisted of pemetrexed 500 mg/m2 and carboplatin area under the concentration-time curve of 5 mg/mL/min, both administered on day 1 of a 21-day cycle. The treatment continued until 6 cycles were completed or until unacceptable toxicity or disease progression were observed.
  
  
  RESULTS
  A total of 62 patients were enrolled. Of these patients, 18 (29%) had a confirmed partial response, whereas the disease remained stable in 34 patients (54.9%) and progressed in 10 patients (16.1%). The median overall survival (OS) was estimated at 14 months (95% CI, 11.8-16.2 months), and the median time to progression was 7 months (95% CI, 5.8-8.2 months). The difference in median OS between the epithelial histologic subtype (16 months) and the sarcomatoid subtype (11 months) was statistically significant.
  
  
  CONCLUSIONS
  This study confirmed the activity of the carboplatin/ pemetrexed combination in the first-line treatment of patients with MPM. It is a viable option, especially in cases in which side effects are generally anticipated.
authors.affiliation: Oncology Unit, 3rd Department of Medicine, Sotiria General Hospital, Athens School of Medicine, Athens, Greece.
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Katirtzoglou
authors.forename: Ioannis
authors.initials: I
authors.lastname: Gkiozos
authors.forename: Nektaria
authors.initials: N
authors.lastname: Makrilia
authors.forename: Emilia
authors.initials: E
authors.lastname: Tsaroucha
authors.forename: Aggeliki
authors.initials: A
authors.lastname: Rapti
authors.forename: Grigorios
authors.initials: G
authors.lastname: Stratakos
authors.forename: Georgios
authors.initials: G
authors.lastname: Fountzilas
authors.forename: Konstantinos N
authors.initials: KN
authors.lastname: Syrigos
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D016190:Carboplatin / Q000008:administration & dosage; D018450:Disease Progression; D005260:Female; D005971:Glutamates / Q000008:administration & dosage; D006147:Guanine / Q000008:administration & dosage / Q000031:analogs & derivatives; D006801:Humans; D008297:Male; D008654:Mesothelioma / Q000188:drug therapy* / Q000401:mortality / Q000503:physiopathology; D008875:Middle Aged; D000068437:Pemetrexed; D010997:Pleural Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000503:physiopathology; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D005971:Glutamates; D000068437:Pemetrexed; D006147:Guanine; D016190:Carboplatin