Epirubicin and gemcitabine as first-line treatment in malignant pleural mesothelioma
| Autor: | Filippo Demarinis, Paolo Pronzato, Domenico Sambiasi, Luigi Portalone, A. Lombardi, Luigi Friggeri, Carlo Crispino, Vito Lorusso, Mauro Signora, Antonio Antilli, Francesco Nunziati |
|---|---|
| Rok vydání: | 2005 |
| Předmět: |
Male
Mesothelioma Cancer Research medicine.medical_specialty Antimetabolites Antineoplastic medicine.medical_treatment Pleural Neoplasms Gastroenterology Deoxycytidine Drug Administration Schedule 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine Maintenance therapy Internal medicine Antineoplastic Combined Chemotherapy Protocols medicine Humans Stage (cooking) Aged Epirubicin Chemotherapy Antibiotics Antineoplastic business.industry General Medicine Middle Aged Survival Analysis Gemcitabine Surgery Clinical trial Treatment Outcome Oncology Tolerability 030220 oncology & carcinogenesis Toxicity Disease Progression Female business medicine.drug |
| Zdroj: | Scopus-Elsevier |
| ISSN: | 0300-8916 |
| Popis: | Malignant pleural mesothelioma represents a rare disease, for which chemotherapy actually remains unsatisfactory. From August 1998 to November 2001, 28 chemo-radio-immunonaive patients were consecutively enrolled in the trial: 22/6 males/females; median age 63 years (range, 45-79); median ECOG PS 1 (range, 0-2). They were treated with epirubicin (100 mg/m2 iv on day 1) plus gemcitabine (1000 mg/m2 iv on days 1 and 8) every 4 weeks for 6 cycles. Patients who responded to chemotherapy (n = 6) were subsequently treated with interleukin-2 (4,500,000 IU) subcutaneously every other day, until progression. A total of 124 epirubicin-gemcitabine cycles were administered (median, 6/patient; range, 2-6). Twenty-six patients were evaluated for toxicity. According to WHO criteria, we observed grade III-IV hematological and gastrointestinal toxicity respectively in 3 patients (11%) and 1 patient (3%). No red cell transfusions were required and no toxic deaths occurred. Two patients (8%) could not be evaluated for response (no therapy performed). According to WHO criteria, the final responses were: partial in 4 patients (14%), stable disease in 19 patients (69%), and progression in 3 patients (10%). In 26 patients, the median survival was 55 weeks (range, 7-222) and median time to progression 30 weeks (range, 4-156). At the time of this writing, no patient is alive. The 1-year survival was 32%, 2-year survival 11%, and 4% at 3 and 4 years. All patients were at stage III, and time to progression was 58 weeks and survival 63.5 weeks, without any toxicity. This multi-center phase II clinical trial showed that epirubicin plus gemcitabine, as a first-line treatment in malignant pleural mesothelioma, has promising activity with a good tolerability profile and symptom palliation. The role of interleukin-2 in maintenance therapy for malignant pleural mesothelioma is encouraging and requires further study. |
| Databáze: | OpenAIRE |
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