Carboplatin in malignant mesothelioma: A phase II study of the cancer and leukemia Group B

Vogelzang, N. J.; Goutsou, Maria; Corson, Joseph M.; Suzuki, Yasunosuke; Graziano, Stephen L.; Aisner, Joseph; Cooper, M. Robert; Coughlin, Kristine; Green, M R

doi:10.1007/bf00685720

Cited by 67 publications

(16 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…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: 99%

Chemotherapy for malignant pleural mesothelioma: past results and recent developments

Tomek¹,

Emri

Krejcy³

et al. 2003

Br J Cancer

View full text Add to dashboard Cite

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.

show abstract

Section: Single-agent Chemotherapymentioning

confidence: 99%

Chemotherapy for malignant pleural mesothelioma: past results and recent developments

Tomek¹,

Emri

Krejcy³

et al. 2003

Br J Cancer

View full text Add to dashboard Cite

show abstract

“…Our combination regimen was chosen because carboplatin has single-agent activity against MPM. Carboplatin has a similar activity to cisplatin, but with milder toxicity, 7,18,19 whereas gemcitabine is active against various solid tumors and alleviates symptoms.…”

Section: Discussionmentioning

confidence: 99%

Gemcitabine combined with carboplatin in patients with malignant pleural mesothelioma

Favaretto

Aversa

Paccagnella³

et al. 2003

Cancer

104

View full text Add to dashboard Cite

BACKGROUNDMalignant pleural mesothelioma (MPM) is increasing rapidly worldwide. Currently, pemetrexed plus cisplatin chemotherapy showed a survival advantage versus cisplatin alone. No impact on patient survival of surgery, radiotherapy, or their combination has been demonstrated.METHODSEight centers in northeastern Italy participated in a Phase II multicenter study. Chemotherapy was comprised of carboplatin area under the concentration‐time curve 5 on Day 1 and gemcitabine 1000 mg/m2 on Days 1, 8, and 15. This cycle was repeated every 4 weeks.RESULTSBetween July 1996 and September 2000, 50 patients were treated. Of the sample, 68% were males, 88% had a Eastern Cooperative Oncology Group performance status score of 0–1, 56% had Stage I–II disease, 68% had epithelioid histology, and 62% had no previous treatments. The delivered dose intensity of gemcitabine was 617 mg/m2 per week, which was 82% of the planned dose (750 mg/m2 per week). For carboplatin, the delivered dose intensity was 80 mg/m2 per week. Overall, 44% of 15th day doses were omitted or reduced. Twenty‐six percent of the patients had partial responses (95% confidence interval: 15–40%) and 24% had disease progression. None of the patients had complete responses. The median response duration was 55 weeks (range, 13–113 weeks). Patients had good clinical benefit. For example, 46% had improved dyspnea, 40% improved in weight, and 26% experienced pain reduction. Patients developed Grade 3–4 leukopenia during 18 cycles (11%) of chemotherapy. Grade 3–4 thrombocytopenia occurred more frequently, i.e., there were 24 episodes (15%) among 17 patients. Grade 3 anemia developed among patients during eight cycles (5%). None of the patients developed Grade 3–4 nonhematologic toxicity. The median survival of this sample of patients was 66 weeks with 53%, 30%, and 20% of patients alive at 1, 2, and 3 years, respectively. The median progression‐free survival period was 40 weeks.CONCLUSIONSThe gemcitabine/carboplatin combination is a valid option in the treatment of MPM due to its acceptable toxicity profile, the good response rate, and the clinical benefit to patients. Minor adjustments in schedule (3‐week cycles instead of 4‐week cycles) would permit a more optimal treatment administration. Cancer 2003;97:2791–7. © 2003 American Cancer Society.DOI 10.1002/cncr.11405

show abstract

“…Virtually every class of chemotherapy has been tested, but few have shown consistent response rates greater than 20% [13]. Many multidrug trials, including four phase II and phase III studies by the Cancer and Leukemia Group B, have shown no clear improvement over single-agent chemotherapy [14,15]. Because systemic chemotherapy has had little effect on the progression of disease, intrapleural chemotherapy also has been evaluated in clinical trials [16,17].…”

Section: Opinion Statementmentioning

confidence: 98%

Photodynamic therapy for mesothelioma

Hahn

Smith

Friedberg

2001

Curr. Treat. Options in Oncol.

View full text Add to dashboard Cite

Multiple trials of traditional cancer therapies for malignant pleural mesothelioma (including surgery, radiation therapy, and chemotherapy) have not convincingly demonstrated that any one treatment is superior to supportive care alone. Although there have been reports of long-term survivors who were treated with aggressive surgery combined with radiation and aggressive multi-agent chemotherapeutic regimens, these patient populations are highly selected and results cannot be generalized to a larger population. Despite attempts to use aggressive multimodality therapies, disease recurs in most patients. Local failure in particular is a large part of the natural history of mesothelioma, especially after surgery alone. Therefore, one of the major considerations in the development of new treatments is the inclusion of aggressive local therapies. Photodynamic therapy (PDT), a local treatment modality, is being evaluated as an adjuvant therapy to surgical resection. Clinical use of PDT requires the use of a photosensitizing agent and light of a wavelength specific to the absorption characteristics of the sensitizer in the presence of oxygen. The treatment effect of PDT is superficial, mostly because of the limited depth of light absorption in tissues. Therefore, it is theoretically an ideal treatment for tissue surfaces and body cavities after surgical debulking procedures. One theoretical advantage of PDT is that it can be used to treat the lung surface after a pleurectomy; therefore, patients may be treated with a pleurectomy rather than with an extrapleural pneumonectomy. Several studies have evaluated the efficacy of PDT in the treatment of mesothelioma. Clinical studies have not proven convincingly that the use of PDT is superior to the use of other adjuvant therapies or to surgery alone. The advent of newer photosensitizers and improved laser technology has led to a renewed interest in evaluating PDT. Additional studies are necessary to determine the role of PDT in the treatment of mesothelioma.

show abstract

Carboplatin in malignant mesothelioma: A phase II study of the cancer and leukemia Group B

Cited by 67 publications

References 11 publications

Chemotherapy for malignant pleural mesothelioma: past results and recent developments

Chemotherapy for malignant pleural mesothelioma: past results and recent developments

Gemcitabine combined with carboplatin in patients with malignant pleural mesothelioma

Photodynamic therapy for mesothelioma

Contact Info

Product

Resources

About