Efficacy and safety of pemetrexed plus cisplatin as first-line chemotherapy in advanced malignant peritoneal mesothelioma

Abstract

Background Malignant peritoneal mesothelioma (MPeM) is a rare cancer for which no standard systemic chemotherapy has been established. While cisplatin plus pemetrexed, the standard treatment for malignant pleural mesothelioma (MPlM), is usually used for MPeM, its efficacy remains unclear. Methods We retrospectively reviewed the medical charts of MPeM patients who had received cisplatin plus pemetrexed as first-line chemotherapy between January 2001 and July 2016 at the National Cancer Center Hospital. Patients received cisplatin 75 mg/m2 and pemetrexed 500 mg/m2 on day1, repeated every 3 weeks until progressive disease, unacceptable toxicities or patient’s refusal to continue. Results A total of 29 MPeM patients received cisplatin plus pemetrexed. Median progression-free survival and overall survival were 7.1 months (95% CI: 4.8–9.3) and 15.4 months (95% CI: 9.5–21.2), respectively. Among 16 patients with measurable lesions, the response rate was 38%. Incidences of grade 3/4 leukopenia, neutropenia, anemia and thrombocytopenia were 21%, 17%, 14% and 3%, respectively. Non-hematological toxicities were mild, and there were no treatment-related deaths. Conclusions Cisplatin plus pemetrexed, showing consistent efficacy with MPlM, can be recommended as first-line treatment for unresectable MPeM patients.

Efficacy of a second-line treatment and prognostic factors in patients with advanced malignant peritoneal mesothelioma: a retrospective study

“…The e cacy of pemetrexed in combination with cisplatin in patients with MPeM has been reported in two studies, with response rates of 20% and 29.8%, respectively, and a median survival of 13.1 months in one study and not reached in the other [6] , [7]. In our retrospective study, the combination of cisplatin and pemetrexed for MPeM was effective, and the median progression-free survival (PFS) and overall survival (OS) were 7.1 and 15.4 months, respectively [8]. Replacing cisplatin with carboplatin has been shown to result in similar treatment e cacy [7] , [9].…”

“…This study was conducted as an expanded analysis of the e cacy of rst-line platinum-based chemotherapy following our previous study [8]. Furthermore, we also evaluated a second-line treatment and explored the prognostic factors in patients who received second-line treatment.…”

Alvopem ® (pemetrexed) safety assessment in patients with non-small cell lung cancer or malignant pleural mesothelioma: a post-marketing surveillance

“…In another study on the efficacy and safety of pemetrexed plus cisplatin as first-line chemotherapy in advanced malignant peritoneal mesothelioma, Nagata et al reported among hematological toxicities, Incidence of grade 3/4 leukopenia, neutropenia, anemia and thrombocytopenia were 21%, 17%, 14% and 3%, respectively [ 28 ]. Moreover, in a study for assessment of efficacy and safety of pemetrexed maintenance chemotherapy for advanced NSCLC in a real-world setting conducted in 2021, authors have mentioned grade 1/2 hematological toxicities as the most commonly reported toxicities with leukopenia in 35.2% and neutropenia in 23.9% of patients [ 29 ].…”

Clinical-pathological Characteristics and Prognostic Factors for Malignant Peritoneal Mesothelioma in the Elderly

“…Chemotherapy is often combined with surgery to treat MPM, which can be delivered in the form of heated intraperitoneal chemotherapy (HIPEC). Nagata Y et al found that cisplatin plus pemetrexed showed consistent e cacy with MPM [34], which can be recommended as rst-line treatment for unresectable MPM. Yan et al reported the median survival of 56 months for 372 patients who received HIPEC and 23 months for those who did not (P = 0.…”