Robust disease control following sequential immunotherapy and radiotherapy in a malignant pleural mesothelioma patient

Purpose This multicenter, phase II clinical study was conducted to evaluate the activity of the combination of pemetrexed and carboplatin in patients with malignant pleural mesothelioma (MPM). Patients and Methods Chemotherapy-naive patients with measurable disease and adequate organ function, who were not eligible for curative surgery, received pemetrexed 500 mg/m2 and carboplatin area under the plasma concentration-time curve of 5 mg/mL/min, administered intravenously every 21 days. All patients received folic acid and vitamin B12 supplementation. Pemetrexed was provided within the Expanded Access Program. Results A total of 102 patients were enrolled. An objective response was achieved in 19 patients (two complete and 17 partial responses), for a response rate of 18.6% (95% CI, 11.6% to 27.5%). Forty-eight patients (47.0%; 95% CI, 37.1% to 57.2%) had stable disease after treatment. Overall, 67 patients (65.7%) achieved disease control (95% CI, 55.6% to 74.8%). Median time to progression was 6.5 months; median overall survival time was 12.7 months. Compliance to treatment was excellent, with a relative dose-intensity of 97% for pemetrexed and 98% for carboplatin. Toxicity was mild, with grade 3 or 4 neutropenia occurring in 9.7% of total cycles and grade 3 or 4 anemia occurring in 3.5% of total cycles. Nonhematologic toxicity was negligible. Conclusion Treatment with pemetrexed and carboplatin was active and well tolerated in patients with MPM. Disease control rate, time to disease progression, and overall survival were similar to the results achieved with the standard regimen of pemetrexed and cisplatin, suggesting that the carboplatin combination could be an alternative option for these patients.

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Does disease control rate (DCR) at 9 and 18 weeks predict overall survival (OS) in patients with malignant pleural mesothelioma (MPM)? An individual patient data combined analysis of 10 European Organisation for Research and Treatment of Cancer (EORTC) Lung Cancer Group (LCG) studies.

Journal of Clinical Oncology ◽

10.1200/jco.2011.29.15_suppl.7025 ◽

2011 ◽

Vol 29 (15_suppl) ◽

pp. 7025-7025

Author(s):

L. Greillier ◽

B. Hasan ◽

P. Baas ◽

J. J. Welch ◽

J. P. Van Meerbeeck ◽

...

Keyword(s):

Lung Cancer ◽

Overall Survival ◽

Disease Control ◽

Malignant Pleural Mesothelioma ◽

Individual Patient Data ◽

Disease Control Rate ◽

Pleural Mesothelioma ◽

Combined Analysis ◽

European Organisation ◽

Cancer Group

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Impact of treatment-free interval (TFI) and disease control rate (DCR) on survival outcome in relapsed malignant pleural mesothelioma (MPM).

Journal of Clinical Oncology ◽

10.1200/jco.2014.32.15_suppl.7584 ◽

2014 ◽

Vol 32 (15_suppl) ◽

pp. 7584-7584

Author(s):

Vanesa Gregorc ◽

Alessandra Bulotta ◽

Maria Grazia Viganò ◽

Domenico Ghio ◽

Gilda Rossoni ◽

...

Keyword(s):

Disease Control ◽

Malignant Pleural Mesothelioma ◽

Survival Outcome ◽

Disease Control Rate ◽

Pleural Mesothelioma ◽

Free Interval

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Phase II Study of Asparagine-Glycine-Arginine–Human Tumor Necrosis Factor α, a Selective Vascular Targeting Agent, in Previously Treated Patients With Malignant Pleural Mesothelioma

Journal of Clinical Oncology ◽

10.1200/jco.2009.27.3649 ◽

2010 ◽

Vol 28 (15) ◽

pp. 2604-2611 ◽

Cited By ~ 81

Author(s):

Vanesa Gregorc ◽

Paolo A. Zucali ◽

Armando Santoro ◽

Giovanni L. Ceresoli ◽

Giovanni Citterio ◽

...

Keyword(s):

Tumor Necrosis Factor ◽

Disease Control ◽

Malignant Pleural Mesothelioma ◽

Tumor Necrosis ◽

Tumor Necrosis Factor Α ◽

Human Tumor ◽

Pleural Mesothelioma ◽

Human Tumor Necrosis Factor ◽

Factor Α ◽

Necrosis Factor

Purpose NGR-hTNF consists of human tumor necrosis factor α (hTNF-α) fused to the tumor-homing peptide asparagine-glycine-arginine (NGR) able to selectively bind an aminopeptidase N isoform overexpressed on tumor blood vessels. Hypervascularity is a prominent and poor-prognosis feature of malignant pleural mesothelioma (MPM). Currently, there are no standard options for patients with MPM who are failing a front-line pemetrexed-based regimen. We explored safety and efficacy of NGR-hTNF in this setting. Patients and Methods Eligible patients had radiologically documented tumor progression and performance status ≤ 2. Primary study aim was progression-free survival (PFS). NGR-hTNF 0.8 μg/m2 was given intravenously every 3 weeks. A subsequent cohort of patients received 0.8 μg/m2 on a weekly basis. Results In the triweekly cohort (n = 43), only one grade 3 drug-related toxicity was noted, and the most common grades 1 to 2 were short-lived chills (71%). The median PFS was 2.8 months (95% CI, 2.3 to 3.3 months). Nineteen patients (44%) had disease control (one had partial response, and 18 had stable diseases) and experienced a median progression-free time of 4.4 months. In the weekly cohort (n = 14), there was no higher toxicity, and median PFS was 3.0 months (95% CI, 1.9 to 4.1 months). Seven patients (50%) had disease control (all stable diseases) and had a median progression-free interval of 9.1 months. In the overall study population (N = 57), median PFS was 2.8 months. Median progression-free time was 4.7 months in twenty-six patients (46%) who achieved disease control. Median survival was 12.1 months. Conclusion The tolerability and disease control of NGR-hTNF 0.8 μg/m2 weekly warrant additional evaluation in patients with advanced MPM.

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Role of CT and modified Response Evaluation Criteria in Solid Tumors (RECIST criteria) in response evaluation of malignant pleural mesothelioma

QJM ◽

10.1093/qjmed/hcab106.018 ◽

2021 ◽

Vol 114 (Supplement_1) ◽

Author(s):

Ass Prof .Dr., Khalid Esmat Allam ◽

Hend Galal Eldeen Mohamed Ali Hassan ◽

Basma Abdelbaset Mohamed

Keyword(s):

Malignant Pleural Mesothelioma ◽

Clinical Evaluation ◽

Evaluation Criteria ◽

Response Assessment ◽

P Value ◽

Pleural Mesothelioma ◽

Response Evaluation ◽

Malignant Pleural Mesothelioma Patient ◽

Modified Recist

Abstract Background Malignant pleural mesothelioma is a rare and aggressive tumor that the growth pattern of it poses unique difficulties in measurement and response assessment . however, robust and reproducible assessment of response is critically important in the conduct, interpretation, and reporting of clinical trials. Objectives The aim of this study is to assess the value of CT and modified RECIST criteria in follow up patients of malignant pleural mesothelioma patient during treatment with chemotherapy . Patients and methods We evaluated 20 malignant pleural mesothelioma patients undergoing to chemotherapy . Tumor thickness is measures perpendicular to the chest wall or mediastinum in two positions at three separate levels on thoracic CT scans. The sum of the six measurements defined a pleural unidimensional measure. A reduction of at least 30% on two occasions 6 weeks apart defined a partial response; an increase of 20% over the nadir measurement known as progressive disease. Patients who fulfilled the criteria for neither PR nor PD called CD .The validity of the modified criteria was gauged by clinical evaluation . Results In our study, CT and modified RECIST criteria were used as the method of choice in response evaluation of malignant pleural mesothelioma .Our study showed as follow up results of each group and comparison between clinical evaluation and modified RECIST criteria show over all accuracy 73.3% with P value = 0.03 and this results confirm accuracy of CT with modified RECIST criteria as good predictor of disease outcome . Conclusion These Modified RECIST criteria for tumor response correlate with clinical evaluation and can be used to measure outcome in pleural mesothelioma.

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