Primary malignant peritoneal mesothelioma is a rare malignancy with an unfavorable prognosis. Pemetrexed has proven effective in the treatment of malignant mesothelioma, alone or in combination with platinum agents. In the present study, chemo-naïve patients were evaluated for the efficacy and safety of the pemetrexed-cisplatin combination.
Methods
Six patients with diffuse peritoneal mesothelioma were treated with 6 cycles of pemetrexed (500 mg/m2) and cisplatin (75 mg/m2). Chemotherapy was administered on an outpatient basis every 3 weeks.
Results
Complete response was observed in 2 patients (33%) and partial response was observed in 3 patients (50%). The estimated median overall survival was 24 months and the estimated median time to disease progression was 9.5 months. The regimen was well tolerated.
Conclusions
Though our data reflect a small sample size, pemetrexed plus cisplatin accomplished a particularly high clinical benefit rate on chemo-naïve patients. Free full text available at www.tumorionline.it
SugarbakerP.H., WelchL.S., MohamedF., GlehenO.: A review of peritoneal mesothelioma at the Washington Cancer Institute.Surg Oncol Clin North Am, 12: 605–621, 2003.
5.
BarattiD., KusamuraS., MartinettiA., SeregniE., OlivaD.G., LaterzaB., DeracoM.: Circulating CA125 in patients with peritoneal mesothelioma treated with cytoreductive surgery and intraperitoneal hyperthermic perfusion.Ann Surg Oncol, 14: 500–508, 2007.
6.
HassanR., AlexanderR., AntmanK., BoffettaP., ChurgA., CoitD., HausnerP., KennedyR., KindlerH., MetintasM., MuttiL., OndaM., PassH., PremkumarA., RoggliV., StermanD., SugarbakerP., TaubR., VerschraegenC.: Current treatment options and biology of peritoneal mesothelioma: meeting summary of the first NIH peritoneal mesothelioma conference.Ann Oncol, 17: 1615–1619, 2006.
7.
FeldmanA.L., LibuttiS.K., PingpankJ.F., BartlettD.L., BeresnevT.H., MavroukakisS.M., SteinbergS.M., LiewehrD.J., KleinerD.E., AlexanderH.R.: Analysis of factors associated with outcome in patients with malignant peritoneal mesothelioma undergoing surgical debulking and intraperitoneal chemotherapy.J Clin Oncol, 21: 4560–4567, 2003.
8.
VogelzangN.J., RusthovenJ.J., SymanowskiJ., DenhamC., KaukelE., RuffieP., GatzemeierU., BoyerM., EmriS., ManegoldC., NiyikizaC., PaolettiP.: Phase III study of pemetrexed in combination with cisplatin versus cisplatin alone in patients with malignant pleural mesothelioma.J Clin Oncol, 21: 2636–2644, 2003.
9.
DimitrovN.V., EgnerJ., BalcuevaE., SuhrlandL.G.: High-dose methotrexate with citrovorum factor and vincristine in the treatment of malignant mesothelioma.Cancer, 50: 1245–1247, 1982.
10.
SolheimO.P., SaeterG., FinnangerA.M., StenwigA.E.: High-dose methotrexate in the treatment of malignant mesothelioma of the pleura. A phase II study.Br J Cancer, 65: 956–960, 1992.
11.
VogelzangN.J., WeissmanL.B., HerndonJE2nd, AntmanK.H., CooperM.R., CorsonJ.M., GreenM.R.: Trimetrexate in malignant mesothelioma: A Cancer and Leukemia Group B Phase II study.J Clin Oncol, 12: 1436–1442, 1994.
12.
KindlerH.L., BelaniC.P., HerndonJ.E.2nd, VogelzangN.J., SuzukiY., GreenM.R.: Edatrexate (10-ethyl-deaza-aminopterin) (NSC #626715) with or without leucovorin rescue for malignant mesothelioma. Sequential phase II trials by the Cancer and Leukemia Group B.Cancer, 86: 1985–1991, 1999.
13.
ScagliottiG.V., ShinD.M., KindlerH.L., VasconcellesM.J., KepplerU., ManegoldC., BurrisH., GatzemeierU., BlatterJ., SymanowskiJ.T., RusthovenJ.J.: Phase II study of pemetrexed with and without folic acid and vitamin B12 as front-line therapy in malignant pleural mesothelioma.J Clin Oncol, 21: 1556–1561, 2003.
14.
BaasP., ArdizzoniA., GrossiF., NackaertsK., NumicoG., Van MarckE., van de VijverM., MonettiF., Smid-GeirnaerdtM.J., van ZandwijkN., DebruyneC., LegrandC., GiacconeG.; EORTC Lung Cancer Group: EORTC Lung Cancer Group: The activity of raltitrexed (Tomudex) in malignant pleural mesothelioma: an EORTC phase II study (08992).Eur J Cancer, 39: 353–357, 2003.
15.
AdjeiA.A.: Pemetrexed (ALIMTA), a novel multitargeted antineoplastic agent.Clin Cancer Res, 10: 4276–4280, 2004.
16.
JänneP.A., WozniakA.J., BelaniC.P., KeohanM.L., RossH.J., PolikoffJ.A., MintzerD.M., TaylorL., AshlandJ., YeZ., MonbergM.J., ObasajuC.K.: Open-label study of pemetrexed alone or in combination with cisplatin for the treatment of patients with peritoneal mesothelioma: outcomes of an expanded access program.Clin Lung Cancer, 7: 40–46, 2005.
17.
CarteniG., ManegoldC., GarciaG.M., SienaS., ZielinskiC.C., AmadoriD., LiuY., BlatterJ., Visseren-GrulC., StahelR.: Malignant peritoneal mesothelioma-Results from the International Expanded Access Program using pemetrexed alone or in combination with a platinum agent.Lung Cancer, 66: 269–270, 2009.
18.
Garcia-CarboneroR., Paz-AresL.: Systemic chemotherapy in the management of malignant peritoneal mesothelioma.Eur J Surg Oncol, 32: 676–681, 2006.
19.
SimonG.R., JanneP.A., LangerC.J., VerschraegenC.F., DowlatiA., GadgeelS.M.: A phase 2 clinical trial of pemetrexed (P) plus gemcitabine (G) as front-line chemotherapy for patients with peritoneal mesothelioma (PM).J Clin Oncol, 23: 16S (abstract 7235), 2005.
20.
NowakA.K., ByrneM.J.: Cisplatin and gemcitabine in malignant mesothelioma.Ann Oncol, 16: 345–351, 2005.
21.
van HaarstJ.M., BaasP., ManegoldCh, SchouwinkJ.H., BurgersJ.A., de BruinH.G., MooiW.J., van KlaverenR.J., de JongeM.J., van MeerbeeckJ.P.: Multicentre phase II study of gemcitabine and cisplatin in malignant pleural mesothelioma.Br J Cancer, 86: 342–345, 2002.
22.
TherasseP., ArbuckS.G., EisenhauerE.A., WandersJ., KaplanR.S., RubinsteinL., VerweijJ., Van GlabbekeM., van OosteromA.T., ChristianM.C., GwytherS.G.: New guidelines to evaluate the response to treatment in solid tumors. European Organization for Research and Treatment of Cancer, National Cancer Institute of the United States, National Cancer Institute of Canada.J Natl Cancer Inst, 92: 205–206, 2000.
23.
KarthausM., MetznerD., MaherG., PlahlA., WertN.: Pemetrexed+cisplatin in patients with malignant peritoneal mesothelioma.J Clin Oncol, 22: 14S (abstract 7201), 2004.
24.
TaylorP., CastagnetoB., DarkG., MarangoloM., ScagliottiG.V., van KlaverenR.J., LabiancaR., SerkeM., SchuetteW., van MeerbeeckJ.P., HeigenerD., LiuY., AdachiS., BlatterJ., von PawelJ.: Single-agent pemetrexed for chemonaïve and pretreated patients with malignant pleural mesothelioma: results of an International Expanded Access Program.J Thorac Oncol, 3: 764–71, 2008.
25.
SantoroA., O'BrienM.E., StahelR.A., NackaertsK., BaasP., KarthausM., EberhardtW., Paz-AresL., SundstromS., LiuY., RipocheV., BlatterJ., Visseren-GrulC.M., ManegoldC.: Pemetrexed plus cisplatin or pemetrexed plus carboplatin for chemonaïve patients with malignant pleural mesothelioma: results of the International Expanded Access Program.J Thorac Oncol, 3: 756–763, 2008.
26.
ObasajuC.K., YeZ., WozniakA.J., BelaniC.P., KeohanM.L., RossH.J., PolikoffJ.A., MintzerD.M., MonbergM.J., JänneP.A.; Pemetrexed Expanded Access Program Investigators: Singlearm, open label study of pemetrexed plus cisplatin in chemotherapy naïve patients with malignant pleural mesothelioma: outcomes of an expanded access program.Lung Cancer, 55: 187–194, 2007.
