Abstract
BACKGROUND No standard second-line chemotherapy has been defined in malignant pleural mesothelioma (MPM). METHODS The activity of oral vinorelbine (VNB) 80 mg/m2 day 1 and 8 q 3 weeks for 4-6 courses after progression to first-line platinum+ pemetrexed was explored in patients (pts) with performance status (PS) 0-2, normal organ functions, and no major comorbidities. RESULTS Fifteen pts included had PS 1 and 2 in 47% and 33%, International Mesothelioma Interest Group stage IV in 67%, 80% were males, 53% had epithelial subtype, and median age was 69 years (range 42-73). Median number of treatment courses was three (range 1-6). Grade 4 toxicities were leucopenia and thrombocytopenia (20% and 7% of pts, respectively) with three episodes of febrile leucopenia (one fatal) and no bleeding episodes. One patient (7%) had a partial response (PR) and disease control rate (PR+no change (NC)) was 47%. Medians of progression-free survival and overall survival were 2.5 months and 4.5 months overall, while they were 5.1 and 5.6 months for patients having PR or NC and 2.0 and 4.0 months in patients with progressive disease as best response. CONCLUSIONS Second-line oral VNB was associated with a 47% disease control rate but also with considerable hematological toxicity and short survival expectancy in this group of poor prognostic MPM pts. More active treatments for patients relapsing after first-line pemetrexed are clearly needed.
| Original language | English |
|---|---|
| Journal | European Journal of Clinical & Medical Oncology |
| Volume | 4 |
| Issue number | 4 |
| Pages (from-to) | 1-7 |
| Publication status | Published - 2012 |