Division of Gastrointestinal Medical Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, Japan.
Division of Gastroenterology and Hepatology, Department of Internal Medicine, The Jikei University School of Medicine, 3-19-18 Nishishinbashi, Minato-ku, Tokyo, Japan.
Jpn J Clin Oncol. 2019 Dec 18;49(11):1004-1008. doi: 10.1093/jjco/hyz104.
Malignant peritoneal mesothelioma (MPeM) is a rare cancer for which no standard systemic chemotherapy has been established. While cisplatin plus pemetrexed, the standard treatment for malignant pleural mesothelioma (MPlM), is usually used for MPeM, its efficacy remains unclear.
We retrospectively reviewed the medical charts of MPeM patients who had received cisplatin plus pemetrexed as first-line chemotherapy between January 2001 and July 2016 at the National Cancer Center Hospital. Patients received cisplatin 75 mg/m2 and pemetrexed 500 mg/m2 on day1, repeated every 3 weeks until progressive disease, unacceptable toxicities or patient's refusal to continue.
A total of 29 MPeM patients received cisplatin plus pemetrexed. Median progression-free survival and overall survival were 7.1 months (95% CI: 4.8-9.3) and 15.4 months (95% CI: 9.5-21.2), respectively. Among 16 patients with measurable lesions, the response rate was 38%. Incidences of grade 3/4 leukopenia, neutropenia, anemia and thrombocytopenia were 21%, 17%, 14% and 3%, respectively. Non-hematological toxicities were mild, and there were no treatment-related deaths.
Cisplatin plus pemetrexed, showing consistent efficacy with MPlM, can be recommended as first-line treatment for unresectable MPeM patients.
恶性腹膜间皮瘤(MPeM)是一种罕见的癌症,目前尚未确立标准的系统化疗方案。顺铂联合培美曲塞是治疗恶性胸膜间皮瘤(MPlM)的标准方案,通常也用于治疗 MPeM,但疗效尚不清楚。
我们回顾性分析了 2001 年 1 月至 2016 年 7 月在国家癌症中心医院接受顺铂联合培美曲塞作为一线化疗的 MPeM 患者的病历。患者在第 1 天接受顺铂 75mg/m2 和培美曲塞 500mg/m2,每 3 周重复一次,直到疾病进展、不可接受的毒性或患者拒绝继续治疗。
共有 29 名 MPeM 患者接受了顺铂联合培美曲塞治疗。中位无进展生存期和总生存期分别为 7.1 个月(95%CI:4.8-9.3)和 15.4 个月(95%CI:9.5-21.2)。在可测量病变的 16 名患者中,缓解率为 38%。3/4 级白细胞减少、中性粒细胞减少、贫血和血小板减少的发生率分别为 21%、17%、14%和 3%。非血液学毒性较轻,无治疗相关死亡。
顺铂联合培美曲塞与 MPlM 疗效一致,可作为不可切除的 MPeM 患者的一线治疗推荐。