A phase II evaluation of cisplatin in unresectable diffuse malignant mesothelioma: A Southwest Oncology Group Study

Zidar, Bernard L.; Green, Stephanie; Pierce, H. Irving; Roach, Ralph W.; Balcerzak, Stanley P.; Militello, Liboria

doi:10.1007/bf00175403

Cited by 83 publications

(21 citation statements)

References 4 publications

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“…Neither cisplatin with a response rate of 13 -14% (Mintzer et al, 1985;Zidar et al, 1988), nor gemcitabine (response rate 0 -31%) (Bischoff et al, 1998;van Meerbeeck et al, 1999;Kindler et al, 2001) have shown great promise as single agents in the treatment of this disease. The additive or synergistic interaction of the two drugs documented in vitro (Peters et al, 1995) and in animal models (Peters et al, 1996) may underlie the useful clinical effects demonstrated in this study.…”

Section: Discussionmentioning

confidence: 99%

A multicentre phase II study of cisplatin and gemcitabine for malignant mesothelioma

et al. 2002

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Our previous phase II study of cisplatin and gemcitabine in malignant mesothelioma showed a 47.6% (95% CI 26.2 -69.0%) response rate with symptom improvement in responding patients. Here we confirm these findings in a multicentre setting, and assess the effect of this treatment on quality of life and pulmonary function. Fifty-three patients with pleural malignant mesothelioma received cisplatin 100 mg m 72 i.v. day 1 and gemcitabine 1000 mg m 72 i.v. days 1, 8, and 15 of a 28 day cycle for a maximum of six cycles. Quality of life and pulmonary function were assessed at each cycle. The best response achieved in 52 assessable patients was: partial response, 17 (33%, 95% CI 20 -46%); stable disease, 31 (60%); and progressive disease, four (8%). The median time to disease progression was 6.4 months, median survival from start of treatment 11.2 months, and median survival from diagnosis 17.3 months. Vital capacity and global quality of life remained stable in all patients and improved significantly in responding patients. Major toxicities were haematological, limiting the mean relative dose intensity of gemcitabine to 75%. This schedule of cisplatin and gemcitabine is active in malignant mesothelioma in a multicentre setting. Investigation of alternative scheduling is needed to decrease haematological toxicity and increase the relative dose intensity of gemcitabine whilst maintaining response rate and quality of life.

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Section: Discussionmentioning

confidence: 99%

A multicentre phase II study of cisplatin and gemcitabine for malignant mesothelioma

et al. 2002

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“…Single-agent cisplatin resulted in a response rate of merely 14.3% and a median survival of 7.5 months (Zidar et al, 1988). Studies using the newer compound carboplatin resulted in similar response rates ranging between 6 and 16% (Mbidde et al, 1986;Raghavan et al, 1990;Vogelzang et al, 1990).…”

Section: Single-agent Chemotherapymentioning

confidence: 98%

Chemotherapy for malignant pleural mesothelioma: past results and recent developments

Tomek¹,

Emri

Krejcy³

et al. 2003

Br J Cancer

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This review summarises the results of previously conducted clinical trials, and subsequently presents data arising from all phase II -III studies on chemotherapy of malignant pleural mesothelioma (MPM) published since the last relevant overview. While response rates exceeding 30% have barely been achieved with established cytotoxic drugs in MPM therapy, novel chemotherapeutic agents and their combinations appear more promising. This applies especially to the antimetabolites, and in particular to pemetrexed that produced response rates of up to 45% in combination with platinum compounds. Raltitrexed combined with oxaliplatin has also been shown to be effective, and gemcitabine -applied as a single agent or in combination with cisplatin -as well as vinorelbine appear to improve the quality of life in patients presenting with MPM. Data can now be more precisely analysed by increasingly implemented randomised studies, applying a standardised staging system, and distinguishing prognostic groups. While chemotherapy for MPM remains a challenging task, important steps have clearly been made in the past years to combat this aggressive disease. The publication of pemetrexed with cisplatin phase III results in a peer-reviewed journal may soon establish a standard of care.

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“…Similarly, cisplatin alone achieves a response rate of only 14% of cases at standard dosage and up to 33% at high dosage [83][84][85][86][87]. High doses of methotrexate alone obtain responses in 37% of cases [88].…”

Section: Chemotherapymentioning

confidence: 99%

Malignant pleural mesothelioma

Boutin¹,

Schlesser²,

Frenay³

et al. 1998

Eur Respir J

170

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The incidence of malignant pleural mesothelioma (MPM) has risen for some decades and is expected to peak between 2010 and 2020. Up to now, no single treatment has been proven to be effective and death usually occurs within about 12-17 months after diagnosis. Perhaps because of this poor prognosis, early screening has incited little interest. However, certain forms may have a better prognosis when diagnosed early and treated by multimodal therapy or intrapleural immunotherapy. Diagnosis depends foremost on histological analysis of samples obtained by thoracoscopy. This procedure allows the best staging of the pleural cavity with an attempt to detect visceral pleural involvement, which is one of the most important prognostic factors. Although radiotherapy seems necessary and is efficient in preventing the malignant seeding after diagnostic procedures in patients, there has been no randomized phase III study showing the superiority of any treatment compared with another. However, for the early-stage disease (stage I) a logical therapeutic approach seems to be neoadjuvant intrapleural treatment using cytokines. For more advanced disease (stages II and III) resectability should be discussed with the thoracic surgeons and a multimodal treatment combining surgery, radiotherapy and chemotherapy should be proposed for a randomized controlled study. Palliative treatment is indicated for stage IV. In any case, each patient should be enrolled in a clinical trial.

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A phase II evaluation of cisplatin in unresectable diffuse malignant mesothelioma: A Southwest Oncology Group Study

Cited by 83 publications

References 4 publications

A multicentre phase II study of cisplatin and gemcitabine for malignant mesothelioma

A multicentre phase II study of cisplatin and gemcitabine for malignant mesothelioma

Chemotherapy for malignant pleural mesothelioma: past results and recent developments

Malignant pleural mesothelioma

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