High-dose methotrexate in the treatment of malignant mesothelioma of the pleura. A phase II study

Solheim, O; Sæter, Gunnar; Finnanger, Anne Marie; Stenwig, Anna E.

doi:10.1038/bjc.1992.200

Cited by 130 publications

(44 citation statements)

References 11 publications

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“…A Norwegian study reported a satisfactory response rate of 37% for high-dose methotrexate and a median survival of 11 months, for trial subjects with an epithelial subtype drawing a particular benefit from this chemotherapy option (Solheim et al, 1992). Sequential multicentre phase II studies conducted by the CALGB have evaluated the activity of the folate antagonist edatrexate, with and without leucovorin rescue.…”

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

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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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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

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“…One reason could be that there was more advanced disease in our patient population than in Solheim's population. Forty-six per cent of our patients had stage III-IV disease compared to 10% in the Solheim study (Solheim et al, 1992). However, the response rate achieved by Solheim lies within the 95% confidence interval of our response rate.…”

Section: Discussionmentioning

confidence: 42%

“…The objective response rate 29% (95% CI 13-51%), confirms MTX as an active agent, but in the light of Solheim's study which achieved a response rate of 37% using the same MTX dose and time schedule, no benefit can be attributed to the addition of IFN in our regime (Solheim et al, 1992). Our slightly lower response rate cannot be attributed to dosage either because we gave full doses of MTX to all except two patients (who had elevations in creatinine levels as a result of the first dose of MTX).…”

Section: Discussionmentioning

confidence: 83%

“…Median survival for all patients was 11 months and 40% of the patients were alive after 1 year. Toxicity was acceptable, with one toxic death and five patients (8%) discontinuing treatment due to toxicity (Solheim et al, 1992).…”

mentioning

confidence: 99%

“…Duration of response and survival of the responders were 2-23 months and 5-35 months respectively (Dimitrov et al, 1982). Solheim et al (1992) reported on 63 patients with pleural mesothelioma who were treated with 4-8 courses of MTX at 3 g with citrovorum rescue. Of 60 patients evaluable for response (assessed using computerized tomography), 37% achieved PR (n = 21) or CR (n = 1).…”

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confidence: 99%

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High-dose methotrexate in combination with interferons in the treatment of malignant pleural mesothelioma

et al. 1999

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Summary Twenty six patients with pleural mesothelioma of UICC stage I-IV excluding M1 disease (46% of whom had stage I disease and 38% stage III disease) were treated intravenously with high dose MTX (3 g) and calcium folinate rescue three times at intervals of 2 weeks and three times at intervals of 3 weeks. Natural interferon (IFN)-α (3 MIU days 2-10) and recombinant IFN-γ 1b (50 µg m -2 on days 2, 6 and 10) were injected subcutaneously after each MTX dose. At the end of MTX treatment the IFNs were continued as maintenance therapy until disease progression. Seven partial responses were observed among 24 patients evaluable for response (response rate 29%, 95% confidence interval 13-51%). Median duration of response was 10 months (range 3-24 months). Median survival was 17 months and 1-year and 2-year survival rates 62% and 31% respectively. The toxicity of the chemo-immunotherapy was acceptable. Treatment was stopped in one patient who developed grade IV neurological toxicity. MTX dose reductions were rare (two patients with grade 1-2 renal toxicity). The combination of high dose MTX and IFN-α and IFN-γ is active against malignant pleural mesothelioma and well-tolerated. The survival rates are encouraging.

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Dihydro-5-azacytidine in malignant mesothelioma

Vogelzang

Herndon

Cirrincione

et al. 1997

Cancer

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High-dose methotrexate in the treatment of malignant mesothelioma of the pleura. A phase II study

Cited by 130 publications

References 11 publications

Chemotherapy for malignant pleural mesothelioma: past results and recent developments

Chemotherapy for malignant pleural mesothelioma: past results and recent developments

High-dose methotrexate in combination with interferons in the treatment of malignant pleural mesothelioma

Dihydro-5-azacytidine in malignant mesothelioma

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