Positive response of a primary malignant pericardial mesothelioma to pemetrexed plus cisplatin followed by pemetrexed maintenance chemotherapy: A case report

Abstract

Abstract. Primary malignant pericardial mesothelioma (PMPM) is a rare tumor with poor prognosis. Surgery is the treatment of choice, but numerous cases are inoperable. For the treatment of inoperable or metastatic cases, systemic chemotherapy is required. However, a standard chemotherapeutic regimen for the treatment of pericardial mesothelioma has not yet been established. Chemotherapy involving pemetrexed and cisplatin has been actively used in the treatment of pleural or peritoneal mesothelioma, and may be considered for the treatment of PMPM. The present study reports the case of a patient with PMPM with lung metastasis who demonstrated a positive response to treatment with pemetrexed and cisplatin followed by pemetrexed maintenance chemotherapy, leading to prolonged progression-free survival for 21 months.

Primary malignant pericardial mesothelioma with difficult antemortem diagnosis: A case report

“…Localized lesions are the only lesions that can be surgically resected for curative purposes, but diffuse lesions are difficult to access[ 12 ]. Although there may have been no effective treatment even if an antemortem diagnosis had been made in this case, chemotherapy and radiotherapy have been effective[ 1 , 4 , 11 , 13 , 14 ], and it was necessary to list this case in the differential diagnosis based on the UCG findings.…”

Malignant Pericardial Mesothelioma Treated Using Volumetric Modulated Arc Therapy With a Simultaneous Integrated Boost

“…Combined with reports of response to combination platinum-pemetrexed chemotherapy in the metastatic setting, there is likely a benefit in the unresectable and adjuvant setting. 11 , 12 Future systemic options for MPcM will likely include immunotherapies, which are currently undergoing investigation in the setting of salvage therapy for pleural mesothelioma (NCT02054806). 13 One such completed study examined 125 patients with pleural mesothelioma with progression after first or second line therapy and randomized them to anti-programmed cell death 1 nivolumab monotherapy or nivolumab plus cytotoxic T-lymphocyte-associated protein 4 ipilimumab combination therapy.…”

18F‑fluorodeoxyglucose imaging of primary malignant pericardial mesothelioma with concurrent pericardial and pleural effusions and bone metastasis: A case report

“…Early and systemic therapy, such as surgical resection, radiotherapy and chemotherapy, are required to prolong patient survival. A doublet chemotherapy regimen (pemetrexed + cisplatin) with pemetrexed maintenance was administered to our patient immediately after surgical resection ( 14 , 15 ). Multiple metastases in the lungs were diagnosed 1 year after the operation and the patient survived for >1.5 years after the diagnosis.…”

“…Multiple metastases in the lungs were diagnosed 1 year after the operation and the patient survived for >1.5 years after the diagnosis. 18 F-FDG imaging may be a particularly useful tool for early diagnosis, staging and response evaluation in patients with PMPM ( 7 , 11 , 15 ).…”