title: Comparison of cisplatin plus pemetrexed and cisplatin plus gemcitabine for the treatment of malignant pleural mesothelioma in Japanese patients.
abstract: BACKGROUND
  Cisplatin plus pemetrexed is a standard front-line chemotherapeutic regimen for inoperable malignant pleural mesothelioma (MPM). However, no clinical trials have compared the efficacy of cisplatin plus pemetrexed and cisplatin plus gemcitabine, which may be comparable based on previous phase II study results. This study aimed at evaluating the efficacy of cisplatin plus pemetrexed and comparing it with that of cisplatin plus gemcitabine in Japanese MPM patients.
  
  
  METHODS
  From July 2002 to December 2011, 13 and 17 consecutive patients with inoperable MPM were treated with cisplatin plus gemcitabine and cisplatin plus pemetrexed, respectively, at the Shizuoka Cancer Center. We reviewed the medical charts of these patients and evaluated their characteristics as well as data regarding drug toxicity and antitumor efficacy.
  
  
  RESULTS
  The response rates were 15% and 35% in the cisplatin plus gemcitabine and cisplatin plus pemetrexed groups, respectively (P=0.4069), while disease control rates were 77%, and 82%, respectively (P=0.9999). Progression-free survival was significantly higher with cisplatin plus pemetrexed (median, 215.5 days) than with cisplatin plus gemcitabine (median, 142.5 days) (P=0.0146; hazard ratio [HR], 0.3552). Overall survival showed a tendency towards being superior with cisplatin plus pemetrexed (median, 597.5 days) compared with cisplatin plus gemcitabine (median, 306.5 days) (P=0.1725, HR, 0.5516). Hematological toxicities, especially thrombocytopenia and neutropenia, tended to be more frequent and severe in the cisplatin plus gemcitabine group.
  
  
  CONCLUSIONS
  Cisplatin plus pemetrexed may be superior and should continue to be the standard front-line chemotherapeutic regimen for inoperable MPM.
authors.affiliation: Divisions of Thoracic Oncology, Shizuoka Cancer Center, Shizuoka, Japan; Divisions of Diagnostic Radiology, Shizuoka Cancer Center, Shizuoka, Japan. Electronic address: tshukuya@juntendo.ac.jp.
authors.forename: Takehito
authors.initials: T
authors.lastname: Shukuya
authors.affiliation: Divisions of Thoracic Oncology, Shizuoka Cancer Center, Shizuoka, Japan. Electronic address: t.takahashi@scchr.jp.
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Takahashi
authors.affiliation: Divisions of Thoracic Oncology, Shizuoka Cancer Center, Shizuoka, Japan. Electronic address: hi.imai@scchr.jp.
authors.forename: Hisao
authors.initials: H
authors.lastname: Imai
authors.affiliation: Divisions of Thoracic Oncology, Shizuoka Cancer Center, Shizuoka, Japan. Electronic address: t.tokito@scchr.jp.
authors.forename: Takaaki
authors.initials: T
authors.lastname: Tokito
authors.affiliation: Divisions of Thoracic Oncology, Shizuoka Cancer Center, Shizuoka, Japan. Electronic address: a.ono@scchr.jp.
authors.forename: Akira
authors.initials: A
authors.lastname: Ono
authors.affiliation: Divisions of Thoracic Oncology, Shizuoka Cancer Center, Shizuoka, Japan. Electronic address: h.akamatsu@scchr.jp.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Akamatsu
authors.affiliation: Divisions of Thoracic Oncology, Shizuoka Cancer Center, Shizuoka, Japan. Electronic address: t.taira@scchr.jp.
authors.forename: Tetsuhiko
authors.initials: T
authors.lastname: Taira
authors.affiliation: Divisions of Thoracic Oncology, Shizuoka Cancer Center, Shizuoka, Japan. Electronic address: h.kenmotsu@scchr.jp.
authors.forename: Hirotsugu
authors.initials: H
authors.lastname: Kenmotsu
authors.affiliation: Divisions of Thoracic Oncology, Shizuoka Cancer Center, Shizuoka, Japan. Electronic address: t.naito@scchr.jp.
authors.forename: Tateaki
authors.initials: T
authors.lastname: Naito
authors.affiliation: Divisions of Thoracic Oncology, Shizuoka Cancer Center, Shizuoka, Japan. Electronic address: ha.murakami@scchr.jp.
authors.forename: Haruyasu
authors.initials: H
authors.lastname: Murakami
authors.affiliation: Department of Respiratory Medicine, Juntendo University, Tokyo, Japan. Electronic address: m.endo@scchr.jp.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Endo
authors.affiliation: Divisions of Thoracic Oncology, Shizuoka Cancer Center, Shizuoka, Japan. Electronic address: nbyamamo@wakayama-med.ac.jp.
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Yamamoto
mesh_terms: D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D044466:Asian People; D002945:Cisplatin / Q000008:administration & dosage / Q000009:adverse effects; D003841:Deoxycytidine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives; D018572:Disease-Free Survival; D005260:Female; D005971:Glutamates / Q000008:administration & dosage / Q000009:adverse effects; D006147:Guanine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000401:mortality; D008297:Male; D008654:Mesothelioma / Q000188:drug therapy* / Q000401:mortality; D000086002:Mesothelioma, Malignant; D008875:Middle Aged; D009503:Neutropenia / Q000139:chemically induced; D000068437:Pemetrexed; D010997:Pleural Neoplasms / Q000188:drug therapy* / Q000401:mortality; D012189:Retrospective Studies; D013921:Thrombocytopenia / Q000139:chemically induced; D016896:Treatment Outcome; D055815:Young Adult; D000093542:Gemcitabine
chemical_list: D005971:Glutamates; D000068437:Pemetrexed; D003841:Deoxycytidine; D006147:Guanine; D002945:Cisplatin; D000093542:Gemcitabine
keywords: Chemotherapy; Cisplatin; Gemcitabine; Malignant pleural mesothelioma; Pemetrexed