title: Successful salvage chemotherapy with gemcitabine and vinorelbine in a malignant pleural mesothelioma patient previously treated with pemetrexed.
abstract: The role of second-line and salvage chemotherapy in malignant pleural mesothelioma treatment is not yet established. We report a case of relapsed malignant pleural mesothelioma in which the patient failed to respond to pemetrexed-based chemotherapy but was successfully treated with gemcitabine and vinorelbine. The patient underwent a left extrapleural pneumonectomy. Three years later she developed anterior chest wall and retroperitoneal masses. Histological findings revealed metastases from the malignant pleural mesothelioma. Although two cycles of carboplatin plus pemetrexed chemotherapy were administered, she had progressive disease. Then, 1000 mg/m(2) gemcitabine and 25 mg/m(2) vinorelbine were administered every 2 weeks. The chemotherapy regimen was tolerated well, and the tumors were remarkably reduced. She was treated with 12 cycles of gemcitabine plus vinorelbine, and 8.5 months of progression-free survival was observed. Gemcitabine plus vinorelbine chemotherapy may be a candidate regimen for salvage chemotherapy against malignant pleural mesotheliomas.
authors.affiliation: First Department of Internal Medicine, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto 390-8621, Japan. agatsuma@shinshu-u.ac.jp
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Agatsuma
authors.forename: Tomonobu
authors.initials: T
authors.lastname: Koizumi
authors.forename: Masanori
authors.initials: M
authors.lastname: Yasuo
authors.forename: Kazuhisa
authors.initials: K
authors.lastname: Urushihata
authors.forename: Kenji
authors.initials: K
authors.lastname: Tsushima
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yamamoto
authors.forename: Masayuki
authors.initials: M
authors.lastname: Hanaoka
authors.forename: Mana
authors.initials: M
authors.lastname: Fukushima
authors.forename: Takayuki
authors.initials: T
authors.lastname: Honda
authors.forename: Keishi
authors.initials: K
authors.lastname: Kubo
mesh_terms: D000328:Adult; D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D018572:Disease-Free Survival; D005260:Female; D005971:Glutamates / Q000627:therapeutic use*; D006147:Guanine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006801:Humans; D008654:Mesothelioma / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000556:secondary; D000068437:Pemetrexed; D010997:Pleural Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology; D012186:Retroperitoneal Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000556:secondary; D016879:Salvage Therapy / Q000379:methods*; D014057:Tomography, X-Ray Computed; D017211:Treatment Failure; D016896:Treatment Outcome; D014747:Vinblastine / Q000008:administration & dosage / Q000031:analogs & derivatives; D000077235:Vinorelbine; D000093542:Gemcitabine
chemical_list: D000964:Antimetabolites, Antineoplastic; D005971:Glutamates; D000068437:Pemetrexed; D003841:Deoxycytidine; D014747:Vinblastine; D006147:Guanine; D000077235:Vinorelbine; D000093542:Gemcitabine