A phase II trial of prolonged, continuous infusion of low-dose gemcitabine plus cisplatin in patients with advanced malignant pleural mesothelioma

Arrieta, Óscar; López-Macías, Diego; Mendoza-García, Víctor Osvaldo; Bacon-Fonseca, Ludwing; Muñoz‐Montaño, Wendy; Macedo-Pérez, Eleazar Omar; Muñiz-Hernández, Saé; Blake-Cerda, M.; Corona-Cruz, José Francisco

doi:10.1007/s00280-014-2429-5

Cited by 27 publications

(22 citation statements)

References 40 publications

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“…Other recommended first-line combination chemotherapy options include (1) pemetrexed/carboplatin, which was assessed in 3 large phase II studies (median survival, 12.7, 14, and 14 months, respectively) and a large expanded access nonrandomized study 34,[51][52][53] ; or (2) gemcitabine/ cisplatin, which was assessed in phase II studies (median survival, 9.6-14.7 months). 35,36,40,54,55 The carboplatin/pemetrexed regimen is a better choice for patients with poor PS or comorbidities. 51 Gemcitabine/cisplatin is only recommended for patients who cannot take pemetrexed.…”

Section: Principles Of Surgerymentioning

confidence: 99%

NCCN Guidelines Insights: Malignant Pleural Mesothelioma, Version 3.2016

Ettinger¹,

Wood²,

Akerley³

et al. 2016

J Natl Compr Canc Netw

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These NCCN Guidelines Insights focus on recent updates to the NCCN Guidelines for Malignant Pleural Mesothelioma (MPM). These NCCN Guidelines Insights discuss systemic therapy regimens and surgical controversies for MPM. The NCCN panel recommends cisplatin/pemetrexed (category 1) for patients with MPM. The NCCN panel also now recommends bevacizumab/cisplatin/pemetrexed as a first-line therapy option for patients with unresectable MPM who are candidates for bevacizumab. The complete version of the NCCN Guidelines for MPM, available at NCCN.org, addresses all aspects of management for MPM including diagnosis, evaluation, staging, treatment, surveillance, and therapy for recurrence and metastasis; NCCN Guidelines are intended to assist with clinical decision-making.

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Section: Principles Of Surgerymentioning

confidence: 99%

NCCN Guidelines Insights: Malignant Pleural Mesothelioma, Version 3.2016

Ettinger¹,

Wood²,

Akerley³

et al. 2016

J Natl Compr Canc Netw

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“…3). Studies consistently show that treatment with gemcitabine/cisplatin doublet achieves comparable results67828. In Slovenian randomized phase II trial comparing pemetrexed/cisplatin and gemcitabine/cisplatin, overall median OS reached 18.6 months and there were no significant differences between groups treatment29.…”

Section: Discussionmentioning

confidence: 94%

Clinical-pharmacogenetic models for personalized cancer treatment: application to malignant mesothelioma

Goričar

Kovač

Dolžan

2017

Sci Rep

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Large interindividual differences in treatment outcome are observed in cancer patients undergoing chemotherapy. Our aim was to develop and validate clinical-pharmacogenetic prediction models of gemcitabine/cisplatin or pemetrexed/cisplatin treatment outcome and develop an algorithm for genotype-based treatment recommendations in malignant mesothelioma (MM). We genotyped 189 MM patients for polymorphisms in gemcitabine, pemetrexed and cisplatin metabolism, transport and drug target genes and DNA repair pathways. To build respective clinical-pharmacogenetic models, pharmacogenetic scores were assigned by rounding regression coefficients. Gemcitabine/cisplatin model was based on training group of 71 patients and included CRP, histological type, performance status, RRM1 rs1042927, ERCC2 rs13181, ERCC1 rs3212986, and XRCC1 rs25487. Patients with higher score had shorter progression-free (PFS) and overall survival (P < 0.001). This model’s sensitivity was 0.615 and specificity 0.812. In independent validation group of 66 patients the sensitivity and specificity were 0.667 and 0.641, respectively. Pemetrexed/cisplatin model was based on 57 patients and included CRP, MTHFD1 rs2236225, and ABCC2 rs2273697. Patients with higher score had worse response and shorter PFS (P < 0.001). This model’s sensitivity was 0.750 and specificity 0.607. In independent validation group of 20 patients the sensitivity and specificity were 0.889 and 0.500, respectively. The proposed algorithm based on these models could enable the choice of the most effective chemotherapy for 85.5% of patients and lead to improved treatment outcome in MM.

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“…A reader interested in this particular treatment will find more information in publications which come from a wide spectrum of countries: Slovenia, India, China, Mexico and Egypt. [123456789]…”

Section: Independent Clinical Research: Illusion or A Real Possibility?mentioning

confidence: 99%

Independent clinical research may alleviate disparities in cancer treatment

Zwitter

2016

Asia-Pacific Journal of Oncology Nursing

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Disparities in cancer care are a reality of the modern world. Unfortunately, current clinical research is in the hands of for-profit pharmaceutical companies and of researchers from the developed world. Problems specific to cancer care in developing countries and among deprivileged populations are ignored. Independent clinical research can offer new valuable knowledge and identify affordable and cost-effective treatments. As such, research not depending on commercial sponsors should become one of the important avenues to alleviate the problem of cancer disparities.

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A phase II trial of prolonged, continuous infusion of low-dose gemcitabine plus cisplatin in patients with advanced malignant pleural mesothelioma

Abstract: Low-dose, prolonged gemcitabine infusion plus cisplatin has acceptable toxicity and high efficacy with improved quality of life, representing an affordable regimen for the low-income population.

Cited by 27 publications

References 40 publications

NCCN Guidelines Insights: Malignant Pleural Mesothelioma, Version 3.2016

NCCN Guidelines Insights: Malignant Pleural Mesothelioma, Version 3.2016

Clinical-pharmacogenetic models for personalized cancer treatment: application to malignant mesothelioma

Independent clinical research may alleviate disparities in cancer treatment

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