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.
Division of Hematology-Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
Seung Tae
ST
Kim
Jun Young
JY
Park
Jeeyun
J
Lee
Joon Oh
JO
Park
Young Suk
YS
Park
Ho Yeong
HY
Lim
Won Ki
WK
Kang
Se Hoon
SH
Park
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