Impact of New Chemotherapeutic agents on the outcome of Egyptian patients with Advanced Malignant Pleural Mesothelioma.

Patients with malignant pleural mesothelioma (MPM) are well known to have poor response to chemotherapy. Aim of this work was to evaluate the efficacy and safety of new chemotherapeutic agents for the treatment of Egyptian MPM patients.

METHODS

The first study was a non-randomized, open-label trial. It included 34 eligible patients who were assigned to receive either cisplatin/ pemetrexed or pemetrexed alone if cisplatin was contraindicated for a maximum of 8 cycles. In the second trial, 21 chemo-naïve patients with histologically proven advanced MPM were included. They received cisplatin and raltitrexed for a maximum of 6 cycles.

RESULTS

In the first trial, the median age was 43.5 years (range 25-69), partial response (PR) was achieved in 37.5%, stable disease (SD) in 50%. Median time to progression (TTP) and overall survival (OS) were 7 and 14 months respectively. Survival at 1 year was 64.7%. No toxicity was observed in 17.6% of patients, grade 3-4 toxicity was evident in 11.8% (neutropenia), 8.8% (anemia), and 2.9% (vomiting and diarrhea). In the second trial, median age was 46 years (range 19- 71), PR was achieved in 23.2%, one complete remission (CR) was reported. SD was noticed in 61.9%. The median TTP and OS were 6 and 12 months respectively. Survival at 1 year was 51.6%.

CONCLUSIONS

Both cisplatin/pemetrexed and cisplatin/ raltitrexed are effective and safe regimens in the treatment of MPM.