title: Re-challenge with pemetrexed in advanced mesothelioma: a multi-institutional experience.
abstract: BACKGROUND
  Although first-line therapy for patients affected by advanced mesothelioma is well established, there is a lack of data regarding the impact of second-line treatment.
  
  
  METHODS
  We retrospectively collected data of patients affected by advanced mesothelioma, already treated with first-line therapy based on pemetrexed and platin, with a response (partial response or stable disease) lasting at least 6 months, and re-treated with a pemetrexed-based therapy at progression. The primary objective was to describe time to progression and overall survival after re-treatment.
  
  
  RESULTS
  Overall across several Italian oncological Institutions we found 30 patients affected by advanced mesothelioma, in progression after a 6-month lasting clinical benefit following a first-line treatment with cisplatin and pemetrexed, and re-challenged with a pemetrexed-based therapy. In these patients we found a disease control rate of 66%, with reduction of pain in 43% of patients. Overall time to progression and survival were promising for a second-line setting of patients with advanced mesothelioma, being 5.1 and 13.6 months, respectively.
  
  
  CONCLUSIONS
  In our opinion, when a patient has a long-lasting benefit from previous treatment with pemetrexed combined with a platin compound, the same treatment should be offered at progression.
authors.affiliation: Medical Oncology, IRCCS, Aviano, PN, Italy. abearz@cro.it
authors.forename: Alessandra
authors.initials: A
authors.lastname: Bearz
authors.forename: Renato
authors.initials: R
authors.lastname: Talamini
authors.forename: Gilda
authors.initials: G
authors.lastname: Rossoni
authors.forename: Antonio
authors.initials: A
authors.lastname: Santo
authors.forename: Vincenzo
authors.initials: V
authors.lastname: de Pangher
authors.forename: Gianpiero
authors.initials: G
authors.lastname: Fasola
authors.forename: Francesco
authors.initials: F
authors.lastname: Rosetti
authors.forename: Adolfo
authors.initials: A
authors.lastname: Favaretto
authors.forename: Vanesa
authors.initials: V
authors.lastname: Gregorc
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Berretta
authors.forename: Sandra
authors.initials: S
authors.lastname: Santarossa
authors.forename: Eleonora
authors.initials: E
authors.lastname: Berto
authors.forename: Umberto
authors.initials: U
authors.lastname: Tirelli
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use*; D005260:Female; D005971:Glutamates / Q000627:therapeutic use*; D006147:Guanine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008654:Mesothelioma / Q000188:drug therapy*; D000068437:Pemetrexed; D010997:Pleural Neoplasms / Q000188:drug therapy*; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D005971:Glutamates; D000068437:Pemetrexed; D006147:Guanine