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Second-Line Chemotherapy

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Malignant Mesothelioma

Conclusion

The role of chemotherapy in malignant mesothelioma has changed since the late 1990s with the emergence of new active regimens, improved image reporting, and high-quality data from large multicenter randomized studies. A review of the literature indicates increasing reports of efficacy of second-line chemotherapy in selected fit patients. The activity of pemetrexed and cisplatin in the first-line setting and the apparent value of post-study chemotherapy within the context of that phase III study have confirmed the sensitivity of some mesotheliomas to chemotherapy. Those data, in turn, have opened the door for exploration of chemotherapy or other novel therapies in the second-line setting for malignant mesothelioma. Last, novel phase II studies are required, indeed vital, to determine active agents and combinations in this setting. Careful analysis of the results of such studies by risk/prognostic group assignment and prior response duration will need to be done. Ultimately the most promising agent(s) will need to be evaluated in a randomized comparison against the current standard of best supportive care.

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Author information

Authors and Affiliations

  1. Department of Medical Oncology, Royal North Shore Hospital, St. Leonards, New South Wales, Australia

    Nick Pavlakis BSc, MBBS, MMed (Clin. Epi.), FRACP

  2. Nevada Cancer Institute, Department of Internal Medicine, University of Nevada School of Medicine, Las Vegas, NV, USA

    Nicholas J. Vogelzang MD

Authors
  1. Nick Pavlakis BSc, MBBS, MMed (Clin. Epi.), FRACP
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  2. Nicholas J. Vogelzang MD
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Editor information

Editors and Affiliations

  1. Thoracic Oncology, Barbara Ann Karmanos Cancer Institute, Harper University Hospital, USA

    Harvey I. Pass MD (Chief and Professor of Surgery and Oncology) (Chief and Professor of Surgery and Oncology)

  2. Wayne State University School of Medicine, Detroit, MI, 48201, USA

    Harvey I. Pass MD (Chief and Professor of Surgery and Oncology) (Chief and Professor of Surgery and Oncology)

  3. Nevada Cancer Institute, USA

    Nicholas J. Vogelzang MD (Director and Clinical Professor) (Director and Clinical Professor)

  4. Department of Internal Medicine, University of Nevada School of Medicine, Las Vegas, NV, 81935, USA

    Nicholas J. Vogelzang MD (Director and Clinical Professor) (Director and Clinical Professor)

  5. Thoracic Oncology, Cardinal Bernardin Cancer Center, Loyola University Chicago, Stritch School of Medicine, Maywood, IL, 60153, USA

    Michele Carbone MD, PhD (Professor of Pathology, Director) (Professor of Pathology, Director)

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© 2005 Springer Science+Business Media, Inc.

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Pavlakis, N., Vogelzang, N.J. (2005). Second-Line Chemotherapy. In: Pass, H.I., Vogelzang, N.J., Carbone, M. (eds) Malignant Mesothelioma. Springer, New York, NY. https://doi.org/10.1007/0-387-28274-2_40

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  • DOI: https://doi.org/10.1007/0-387-28274-2_40

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-0-387-22949-2

  • Online ISBN: 978-0-387-28274-9

  • eBook Packages: MedicineMedicine (R0)

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