Publication details
Pemetrexed and Cisplatin in Malignant Pleural Mesothelioma - Czech Experience
| Authors | |
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| Year of publication | 2015 |
| Type | Conference abstract |
| MU Faculty or unit | |
| Citation | |
| Description | Background: Malignant Pleural Mesotelioma (MPM) is a tumour with extremely unfavourable prognosis. Early diagnostic is rarely possible and chemotherapy has limited value in prolongation of survival. Pemetrexed with platinum is the standard 1st line chemotherapy. In the Czech Republic, the incidence of MPM is influenced mostly by former industry processing asbestos for roofs, other parts of buildings and isolation materials. Any work with asbetos is prohibited in the mean time. Methods: Treatment with pemetrexed and cisplatin was evaluated in a prospective study. Data of consecutive patients from 9 centers were prospectively collected from January 2008 till February 2015. Altogether 181 patients (47 women, 134 men) were evaluated. Mean age was 62 years, 71 pts were non smokers, 47 smokers, 61 ex smokers. Professional/ nonprofessional exposure was reported in 44/ 18 pts. Histology: 119 epithelial, 20 mixed, 12 sarcomatoid, not specified in 30 pts, TNM st.: I/II/III/IV in 19/32/48/78 pts, not assessed in 4 pts, PS: 0/1/2 in 39/130/12 pts. Results: Median of treatment was 18.5 weeks. Most frequent side effects (Gr 3, 4): leucopenia in 22, neutropenia in 15, anaemia in 15, trombocytopenia in 6, nausea/vomiting in 19, fatigue in 8 pts. Therapeutic response: CR in 5, PR in 47, SD 85, PD in 21 pts, overall disease control was 75.6 %. The median of overall survival (OS) was 19.8 months (16.2; 23.4), 1 year survival 67.9% (48.3; 71.5). Median of progression free survival (PFS) was 9.1 months (7.6; 10.7). Differences of survival were compared according to sex, smoking history, age, PS, TNM stage, treatment associated AE occurrence, type of exposure and histology. Significantly different results were achieved according to PS,TNM, exposure, AE and histology. Conclusion: Treatment of MPM with pemetrexed and cisplatinum in routine practice is effective and well tolerated. Prognosis is still poor and it is influenced by several clinical markers. Longer survival can be expected in PS 0, TNM I/II, unknown asbestos exposure, epitheloid histology and no treatment associated AE. |