The efficacy of the frontline platinum-based combination chemotherapy in malignant peritoneal mesothelioma.
OBJECTIVE
Malignant peritoneal mesothelioma is a rare neoplasm that accounts for ∼1 per 1 million has limited data regarding its frontline therapy. We investigated the treatment outcomes in patients with malignant peritoneal mesothelioma receiving frontline cisplatin-based combination chemotherapy.


METHODS
We analyzed 14 patients with malignant peritoneal mesothelioma who had been treated by frontline cisplatin-based combination chemotherapy between January 2005 and March 2009. The chemotherapeutic agent added to platinum was gemcitabine in one patient, cyclophosphamide-doxorubicin in three patients and pemetrexed in 10 patients.


RESULTS
The confirmed overall response rate was 35.7% and the disease control rate was 71.4%. In all patients, two complete responses and three partial responses were observed (overall response rate, 35.7%). Stable disease was observed in five patients (35.7%). The median progression free survival was 4.4 months (95% CI, 0.6-9.0) and the median overall survival was 20.1 months (95% CI, 12.7-28.5). There was significant differences for progression free survival (P = 0.031) according to the different chemotherapeutic agents (pemetrexed versus non-pemetrexed agents) added to platinum. Grade 3 or 4 hematologic toxicities included leukopenia in one patient and anemia in three patients. There were no Grade 3 or 4 non-hematologic toxicities or treatment-related deaths.


CONCLUSIONS
The platinum-based combination chemotherapy showed moderate activity and a favorable toxicity profile as a frontline treatment for patients with malignant peritoneal mesothelioma. Pemetrexed in combination with platinum showed improved survival outcomes as compared with other combination regimens combined with platinum.
Kim
Seung Tae
ST
Division of Hematology-Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
Park
Jun Young
JY
Lee
Jeeyun
J
Park
Joon Oh
JO
Park
Young Suk
YS
Lim
Ho Yeong
HY
Kang
Won Ki
WK
Park
Se Hoon
SH
D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002945:Cisplatin / Q000008:administration & dosage; D003520:Cyclophosphamide / Q000008:administration & dosage; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D000077143:Docetaxel; D004317:Doxorubicin / Q000008:administration & dosage; D005260:Female; D005971:Glutamates / Q000008:administration & dosage; D006147:Guanine / Q000008:administration & dosage / Q000031:analogs & derivatives; D006801:Humans; D008297:Male; D008654:Mesothelioma / Q000188:drug therapy* / Q000473:pathology; D008875:Middle Aged; D000068437:Pemetrexed; D010534:Peritoneal Neoplasms / Q000188:drug therapy* / Q000473:pathology; D010997:Pleural Neoplasms / Q000188:drug therapy* / Q000556:secondary; D015996:Survival Rate; D043823:Taxoids / Q000008:administration & dosage; D016896:Treatment Outcome; D000093542:Gemcitabine
D005971:Glutamates; D043823:Taxoids; D000068437:Pemetrexed; D003841:Deoxycytidine; D000077143:Docetaxel; D006147:Guanine; D004317:Doxorubicin; D003520:Cyclophosphamide; D002945:Cisplatin; D000093542:Gemcitabine