Pemetrexed plus carboplatin in elderly patients with malignant pleural mesothelioma: combined analysis of two phase II trials

A minority of patients with malignant pleural mesothelioma is eligible for surgical treatment; most are candidates for

G L Ceresoli

2008

Scholarcy highlights

  • A minority of patients with malignant pleural mesothelioma is eligible for surgical treatment; most are candidates for
  • A large phase III trial testing pemetrexed and cisplatin vs cisplatin alone in 448 chemo-naive patients with MPM showed a significant advantage in survival, time to progression and response rate with the combined regimen
  • Patient characteristics in terms of gender, Eastern Cooperative Oncology Group performance status, histology and stage were similar in the two age groups
  • Patients account for the majority of all new cancer cases
  • In a recent report on more than 1700 chemo-naive MPM patients treated within the International Expanded Access Program, a nonrandomized open-label safety study of pemetrexed as a single agent or in combination with platinum derivatives, the combination of pemetrexed with either carboplatin or cisplatin resulted in similar efficacy and tolerability
  • No patient experienced a complete response in the X70 years group, whereas a partial response was achieved in seven patients, for an objective RR of 14.6%
  • Only 11 patients were X75 years; the results of our study should be regarded with caution with respect to the ‘oldest of the old’, because no consistent data are available on the risk/benefit ratio of pemetrexed and carboplatin chemotherapy in this small subset of patients
  • Our data suggest that chemotherapy with pemetrexed and carboplatin is effective and safe in elderly patients with good performance status affected by malignant pleural mesothelioma

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