Retreatment of recurrent malignant pleural mesothelioma with cisplatin and pemetrexed |
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Authors: | Hidetoshi Hayashi Isamu Okamoto Yasuko Ichikawa Masaki Miyazaki Hiroshige Yoshioka Kei Kunimasa Kazuhiko Nakagawa |
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Institution: | (1) Department of Medical Oncology, Kinki University School of Medicine, 377-2 Ohno-higashi, Osaka-Sayama Osaka, 589-8511, Japan;(2) Department of Respiratory Medicine, Kurashiki Central Hospital, 1-1-1 Miwa, Kurashiki Okayama, 710-0047, Japan; |
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Abstract: | Combination chemotherapy with cisplatin and pemetrexed is the most active first-line regimen for malignant pleural mesothelioma
(MPM). However, no drugs have been approved for second-line treatment of MPM, with effective regimens remaining to be identified
for patients in relapse. We have now evaluated the combination of cisplatin and pemetrexed for retreatment of patients with
recurrent MPM. Four men with MPM, all of whom received initial treatment with cisplatin and pemetrexed, underwent retreatment
with this drug combination. Two of the patients achieved an objective response to the first-line chemotherapy with no evidence
of disease progression for 6.4 or 11.4 months, respectively. The other two patients had stable disease with a duration of
7.8 or 5.0 months, respectively. The two patients who showed an objective response to first-line chemotherapy showed a partial
response to retreatment, with a time to progression of 5.0 or 8.2 months, whereas the other two patients had progressive disease
with a time to progression of 1.0 or 1.4 months, respectively. Retreatment with cisplatin plus pemetrexed was generally well
tolerated. Retreatment with cisplatin and pemetrexed is a potential therapeutic option for certain patients with recurrent
epithelioid MPM, possibly including those who show tumor regression with a time to progression of 6 months or more after the
initial chemotherapy. Further studies are warranted to evaluate the efficacy of such retreatment and to clarify the criteria
for patient selection. |
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