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Chemotherapy for Malignant Pleural Mesothelioma

  • Malignant Mesothelioma
  • Published:
Current Treatment Options in Oncology Aims and scope Submit manuscript

Opinion statement

All MPM patients with a good performance status should be considered for enrollment on clinical trials. With that said, the standard frontline therapy for fit MPM patients remains an antifolate/platinum doublet, based on large, well powered randomized clinical trials that showed not only a survival benefit for antifolate/platinum regimens but also improvements in quality of life and/or symptoms. For less fit patients, single agents can be used as frontline therapy. In the second line setting, there is benefit from retreatment with single agent pemetrexed after prior exposure to that agent, as well as after exposure to other chemotherapeutic agents. Other single chemotherapy agents and combinations are viable options for fit patients who have had relatively long time to progression after their frontline therapy. Additionally, several prognostic scales designed for MPM (CALGB and EORTC) provide additional means to better select patients for frontline and second line chemotherapy.

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References and Recommended Reading

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Merritt N, Blewett CJ, Miller JD, Bennett WF, Young JE, Urschel JD. Survival after conservative (palliative) management of pleural malignant mesothelioma. J Surg Oncol. 2001;78:171–4.

    Article  PubMed  CAS  Google Scholar 

  2. Ruffie P, Feld R, Minkin S, Cormier Y, Boutan-Laroze A, Ginsberg R, et al. Diffuse malignant mesothelioma of the pleura in Ontario and Quebec: a retrospective study of 332 patients. J Clin Oncol. 1989;7:1157–68.

    PubMed  CAS  Google Scholar 

  3. Jassem J, Ramlau R, Santoro A, Schuette W, Chemaissani A, Hong S, et al. Phase III trial of pemetrexed plus best supportive care compared with best supportive care in previously treated patients with advanced malignant pleural mesothelioma. J Clin Oncol. 2008;26:1698–704.

    Article  PubMed  CAS  Google Scholar 

  4. Muers MF, Stephens RJ, Fisher P, Darlison L, Higgs CM, Lowry E, et al. Active symptom control with or without chemotherapy in the treatment of patients with malignant pleural mesothelioma (MS01): a multicentre randomised trial. Lancet. 2008;371:1685–94.

    Article  PubMed  CAS  Google Scholar 

  5. Vogelzang NJ, Rusthoven JJ, Symanowski J, Denham C, Kaukel E, Ruffie P, et al. Phase III study of pemetrexed in combination with cisplatin versus cisplatin alone in patients with malignant pleural mesothelioma. J Clin Oncol. 2003;21:2636–44.

    Article  PubMed  CAS  Google Scholar 

  6. Ceresoli GL, Zucali PA, Favaretto AG, Grossi F, Bidoli P, Del Conte G, et al. Phase II study of pemetrexed plus carboplatin in malignant pleural mesothelioma. J Clin Oncol. 2006;24:1443–8.

    Article  PubMed  CAS  Google Scholar 

  7. van Meerbeeck JP, Gaafar R, Manegold C, van Klaveren RJ, Van Marck EA, Vincent M, et al. Randomized phase III study of cisplatin with or without raltitrexed in patients with malignant pleural mesothelioma: an intergroup study of the European Organisation for Research and Treatment of Cancer Lung Cancer Group and the National Cancer Institute of Canada. J Clin Oncol. 2005;23:6881–9.

    Article  PubMed  Google Scholar 

  8. Hollen PJ, Gralla RJ, Liepa AM, Symanowski JT, Rusthoven JJ. Adapting the Lung Cancer Symptom Scale (LCSS) to mesothelioma: using the LCSS-Meso conceptual model for validation. Cancer. 2004;101:587–95.

    Article  PubMed  Google Scholar 

  9. Bottomley A, Gaafar R, Manegold C, Burgers S, Coens C, Legrand C, et al. Short-term treatment-related symptoms and quality of life: results from an international randomized phase III study of cisplatin with or without raltitrexed in patients with malignant pleural mesothelioma: an EORTC Lung-Cancer Group and National Cancer Institute, Canada. Intergroup Study J Clin Oncol. 2006;24:1435–42.

    CAS  Google Scholar 

  10. van den Bogaert DP, Pouw EM, van Wijhe G, Vernhout RM, Surmont VF, Hoogsteden HC, et al. Pemetrexed maintenance therapy in patients with malignant pleural mesothelioma. J Thorac Oncol. 2006;1:25–30.

    Article  PubMed  Google Scholar 

  11. Kalmadi SR, Rankin C, Kraut MJ, Jacobs AD, Petrylak DP, Adelstein DJ, et al. Gemcitabine and cisplatin in unresectable malignant mesothelioma of the pleura: a phase II study of the Southwest Oncology Group (SWOG 9810). Lung Cancer. 2008;60:259–63.

    Article  PubMed  Google Scholar 

  12. Kindler HL, van Meerbeeck JP. The role of gemcitabine in the treatment of malignant mesothelioma. Semin Oncol. 2002;29:70–6.

    Article  PubMed  CAS  Google Scholar 

  13. Schutte W, Blankenburg T, Lauerwald K, Schreiber J, Bork I, Wollscgkaeger B, et al. A multicenter phase II study of gemcitabine and oxaliplatin for malignant pleural mesothelioma. Clin Lung Cancer. 2003;4:294–7.

    Article  PubMed  Google Scholar 

  14. Scagliotti GV, Shin DM, Kindler HL, Vasconcelles MJ, Keppler U, Manegold C, et al. Phase II study of pemetrexed with and without folic acid and vitamin B12 as front-line therapy in malignant pleural mesothelioma. J Clin Oncol. 2003;21:1556–61.

    Article  PubMed  CAS  Google Scholar 

  15. Steele JP, Shamash J, Evans MT, Gower NH, Tischkowitz MD, Rudd RM. Phase II study of vinorelbine in patients with malignant pleural mesothelioma. J Clin Oncol. 2000;18:3912–7.

    PubMed  CAS  Google Scholar 

  16. Lerner HJ, Schoenfeld DA, Martin A, Falkson G, Borden E. Malignant mesothelioma. The Eastern Cooperative Oncology Group (ECOG) experience. Cancer. 1983;52:1981–5.

    Article  PubMed  CAS  Google Scholar 

  17. Magri MD, Veronesi A, Foladore S, De Giovanni D, Serra C, Crismancich F, et al. Epirubicin in the treatment of malignant mesothelioma: a phase II cooperative study. The North-Eastern Italian Oncology Group (GOCCNE)--Mesothelioma Committee. Tumori. 1991;77:49–51.

    PubMed  CAS  Google Scholar 

  18. Steele JP, O’Doherty CA, Shamash J, Evans MT, Gower NH, Tischkowitz MD, et al. Phase II trial of liposomal daunorubicin in malignant pleural mesothelioma. Ann Oncol. 2001;12:497–9.

    Article  PubMed  CAS  Google Scholar 

  19. Ceresoli, G. L., Zucali, P. A., De Vincenzo, F., Gianoncelli, L., Simonelli, M., Lorenzi, E., Ripa, C., Giordano, L., and Santoro, A. Retreatment with pemetrexed-based chemotherapy in patients with malignant pleural mesothelioma. Lung Cancer, 2011. This study reports the effectiveness of re-exposure to pemetrexed in MPM patients treated with front-line pemetrexed-based therapy with an excellent safety profile.

  20. Janne PA, Wozniak AJ, Belani CP, Keohan ML, Ross HJ, Polikoff JA, et al. Pemetrexed alone or in combination with cisplatin in previously treated malignant pleural mesothelioma: outcomes from a phase IIIB expanded access program. J Thorac Oncol. 2006;1:506–12.

    Article  PubMed  Google Scholar 

  21. Taylor P, Castagneto B, Dark G, Marangolo M, Scagliotti GV, van Klaveren RJ, et al. Single-agent pemetrexed for chemonaive and pretreated patients with malignant pleural mesothelioma: results of an International Expanded Access Program. J Thorac Oncol. 2008;3:764–71.

    Article  PubMed  Google Scholar 

  22. Stebbing, J., Powles, T., McPherson, K., Shamash, J., Wells, P., Sheaff, M. T., Slater, S., Rudd, R. M., Fennell, D., and Steele, J. P. The efficacy and safety of weekly vinorelbine in relapsed malignant pleural mesothelioma. Lung Cancer, 63: 94–97, 2009.

    Article  PubMed  Google Scholar 

  23. Zucali PA, Ceresoli GL, Garassino I, De Vincenzo F, Cavina R, Campagnoli E, et al. Gemcitabine and vinorelbine in pemetrexed-pretreated patients with malignant pleural mesothelioma. Cancer. 2008;112:1555–61.

    Article  PubMed  CAS  Google Scholar 

  24. Porta C, Zimatore M, Bonomi L, Imarisio I, Paglino C, Sartore-Bianchi A, et al. Raltitrexed-Oxaliplatin combination chemotherapy is inactive as second-line treatment for malignant pleural mesothelioma patients. Lung Cancer. 2005;48:429–34.

    Article  PubMed  Google Scholar 

  25. Fizazi K, Doubre H, Le Chevalier T, Riviere A, Viala J, Daniel C, et al. Combination of raltitrexed and oxaliplatin is an active regimen in malignant mesothelioma: results of a phase II study. J Clin Oncol. 2003;21:349–54.

    Article  PubMed  CAS  Google Scholar 

  26. Fennell DA, Steele JP, Shamash J, Evans MT, Wells P, Sheaff MT, et al. Efficacy and safety of first- or second-line irinotecan, cisplatin, and mitomycin in mesothelioma. Cancer. 2007;109:93–9.

    Article  PubMed  CAS  Google Scholar 

  27. Curran D, Sahmoud T, Therasse P, Van Meerbeeck J, Postmus PE, Giaccone G. Prognostic factors in patients with pleural mesothelioma: the European Organization for Research and Treatment of Cancer experience. J Clin Oncol. 1998;16:145–52.

    PubMed  CAS  Google Scholar 

  28. Zucali P, Destro A Ceresoli G et al. The role of thymidylate syntase (TS) and excision repair cross-complementing group 1 (ERCC1) immunohistochemical expression in malignant pleural mesothelioma patients treated with pemetrexed and carboplatin. Presented at European Conference on Clinical Oncology (ECCO), 2009.Abstr ER-1513a. 2010.

  29. Righi, L., Papotti, M. G., Ceppi, P., Bille, A., Bacillo, E., Molinaro, L., Ruffini, E., Scagliotti, G. V., and Selvaggi, G. Thymidylate synthase but not excision repair cross-complementation group 1 tumor expression predicts outcome in patients with malignant pleural mesothelioma treated with pemetrexed-based chemotherapy. J Clin Oncol., 28: 1534–1539, 2010.

    Article  PubMed  CAS  Google Scholar 

  30. Stark M, Wichman C, Avivi I, Assaraf YG. Aberrant splicing of folylpolyglutamate synthetase as a novel mechanism of antifolate resistance in leukemia. Blood. 2009;113:4362–9.

    Article  PubMed  CAS  Google Scholar 

  31. Su C, Zhou S, Zhang L, Ren S, Xu J, Zhang J, et al. ERCC1, RRM1 and BRCA1 mRNA expression levels and clinical outcome of advanced non-small cell lung cancer. Med.Oncol. 2010.

  32. Reynolds C, Obasaju C, Schell MJ, Li X, Zheng Z, Boulware D, et al. Randomized phase III trial of gemcitabine-based chemotherapy with in situ RRM1 and ERCC1 protein levels for response prediction in non-small-cell lung cancer. J Clin Oncol. 2009;27:5808–15.

    Article  PubMed  CAS  Google Scholar 

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Disclosure

L. Garland received payment from Eli Lilly for the development of educational presentations.

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Authors and Affiliations

  1. Arizona Cancer Center, University of Arizona College of Medicine, Tucson, AZ, 85724, USA

    Linda L Garland MD

  2. Arizona Cancer Center, Suite 1969H, 1515 N. Campbell Ave., Tucson, AZ, 85724, USA

    Linda L Garland MD

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Garland, L.L. Chemotherapy for Malignant Pleural Mesothelioma. Curr. Treat. Options in Oncol. 12, 181–188 (2011). https://doi.org/10.1007/s11864-011-0152-6

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  • DOI: https://doi.org/10.1007/s11864-011-0152-6

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