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Salvage treatment in patients with recurrent or resistant malignant pleura mesothelioma. A retrospective study from tertiary oncology department

Andriani Charpidou, George Tsironis, Sofia Tsagouli, Aris Nikolaou, Antonis Bassias, Ilias Kainis, Marios Zontanos, Sotiris Tsimpoukis, Kosts Syrigos
European Respiratory Journal 2016 48: PA5074; DOI: 10.1183/13993003.congress-2016.PA5074
Andriani Charpidou
1Ondology Unit, 3rd Dpt of Internal Medicine, University of Athens, Athens, Greece
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George Tsironis
2Oncology Dpt Alexandra Hospital, University of Athens, Athens, Greece
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Sofia Tsagouli
1Ondology Unit, 3rd Dpt of Internal Medicine, University of Athens, Athens, Greece
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Aris Nikolaou
1Ondology Unit, 3rd Dpt of Internal Medicine, University of Athens, Athens, Greece
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Antonis Bassias
1Ondology Unit, 3rd Dpt of Internal Medicine, University of Athens, Athens, Greece
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Ilias Kainis
310th Dpt Pulmonary Medicine, Sotiria Hospital, Athens, Greece
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Marios Zontanos
1Ondology Unit, 3rd Dpt of Internal Medicine, University of Athens, Athens, Greece
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Sotiris Tsimpoukis
1Ondology Unit, 3rd Dpt of Internal Medicine, University of Athens, Athens, Greece
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Kosts Syrigos
1Ondology Unit, 3rd Dpt of Internal Medicine, University of Athens, Athens, Greece
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Abstract

Introduction: The platinum- pemetrexed doublet is the golden standard for the first line chemotherapy in Malignant Mesothelioma (MM) . As a result of very often relapse, second line chemotherapy choice is crucial for patients survival.

Methods: A number of 98 patients with MM, treated in a tertiary Oncology Unit were reviewed and analyzed.

Results: 50 patients (86%M/ 14%F, median age 66 years, 74% PS 0-1, 98% pleural MM, 82,93% with epithelial histology) received second line chemotherapy, resulting in 6,25% PR, 25% SD, 31,25% DC and 56,25% PD Median PFS of 3,02 months (95%CI 2,72- 4,89), 18,98 months mOS (95%CI 16,16- 23,09) and 6,93 months median survival from the start of second line (95%CI 5,02- 10,38).

48% of patients (24) received a taxane– gemcitabine with 0% PR, 21,74% SD, 21,74% DC, 69,57% PD, 2,98m mPFS (95%CI 2,59-3,38), 15,34m mOS (95%CI 11,43- 20,50) and 5,88m m2LS (95%CI 2,85- 8,41).

18% (9) had docetaxel monotherapy. None of them had achieved PR, and 55,56% progressed resulting in 3,02m mPFS (95%CI 0,78- 9,39), 22,96m mOS (95%CI 6,99- ) and 5,48m m2LS (95%CI 0,88- ).

Finally 8 patients (16%) received the third most common second line option,with pemetrexed doublet (6/ 12%) or pemetrexed monotherapy (2/ 4%). The 14,29% of them achieved PR, 57,14% SD, 71,43% DC and 28,57%PD resulting in 7,35m mPFS (95%CI 2,06- 32,52), 29,20m mOS (95%CI 18,98- ) and 11,13m m2LS (95%CI 6,66- ).

Conclusions: Re-challenge therapy with pemetrexed is the most effective solution. Limitation of the study is the heterogeneity ot treatment groups.

  • Mesothelioma
  • Lung cancer / Oncology
  • Copyright ©the authors 2016
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Salvage treatment in patients with recurrent or resistant malignant pleura mesothelioma. A retrospective study from tertiary oncology department
Andriani Charpidou, George Tsironis, Sofia Tsagouli, Aris Nikolaou, Antonis Bassias, Ilias Kainis, Marios Zontanos, Sotiris Tsimpoukis, Kosts Syrigos
European Respiratory Journal Sep 2016, 48 (suppl 60) PA5074; DOI: 10.1183/13993003.congress-2016.PA5074

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Salvage treatment in patients with recurrent or resistant malignant pleura mesothelioma. A retrospective study from tertiary oncology department
Andriani Charpidou, George Tsironis, Sofia Tsagouli, Aris Nikolaou, Antonis Bassias, Ilias Kainis, Marios Zontanos, Sotiris Tsimpoukis, Kosts Syrigos
European Respiratory Journal Sep 2016, 48 (suppl 60) PA5074; DOI: 10.1183/13993003.congress-2016.PA5074
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