April 13th, 2007. Multicenter trial of neo-adjuvant chemotherapy followed by extrapleural pneumonectomy in malignant pleural mesothelioma
Conclusions: The observed rate of operability is promising. A median survival of 23 months for patients undergoing EPP compares favourably with the survival reported from single center studies of upfront surgery. This approach was not associated with an increase in psychological distress.
Conclusion: Induction chemotherapy with gemcitabine and cisplatin followed by EPP and adjuvant RT for locally advanced MPM is feasible and leads to a better median overall survival than that previously reported with EPP and RT alone.
April 6th, 2007. Four-Modality Therapy in Malignant Pleural Mesothelioma: A Phase II Study
Conclusion: The four-modality treatment that we adopted for advanced-stage MPM was feasible, well tolerated by most of the patients, and produced a favorable median survival. This treatment approach warrants further investigation.
Conclusions: In MPM, the combined modality approach using the Carboplatin/Gemcitabine combination as induction chemotherapy is feasible, with good results in terms of survival and morbidity. Our results are similar to those of other studies using a heavier modality treatment.
February 22nd, 2007. Preliminary Data Suggestive Of A Novel Translational Approach To Mesothelioma Therapy: Imatinib Mesylate With Gemcitabine Or Pemetrexed
Among chemotherapeutics tested in combination, Imatinib synergizes with Gemcitabine and Pemetrexed. We provide a rationale for a novel translational approach to mesothelioma therapy, relying on enhancement of tumor chemosensitivity, via inhibition of Akt.
Conclusions: The multimodality treatment we adopted for stage II-III MPM was feasible, well tolerated by most of the patients and produced a favourable outcome. New targeted therapies are awaited for further improvements in the treatment of this disease.
December 19th, 2006. A retrospective analysis of malignant pleural mesothelioma patients treated either with chemotherapy or best supportive care between 1990 and 2005; A single institution experience
We observed that stages 3 and 4 patients with epithelial cell type got benefit from CT. Especially, of epithelial cell type stages 1 and 2 should receive multimodal treatment.
December 6th, 2006. A case of malignant mesothelioma presenting with recurrent pneumothorax
The histological examination of the biopsied subcutaneous tumor showed mixed type malignant pleural mesothelioma. Chemotherapy with gemcitabine and vinorelbine could not control the progression.
November 8th, 2006. Malignant pleural mesothelioma in a 14-year-old boy with right aortic arch
As the disease was not changed after combination chemotherapy with three cycles of cisplatin and gemcitabine, we performed left extrapleural pneumonectomy, including resection of the pericardium and diaphragm for MPM, and aortopexy for right aortic arch. The postoperative course was uneventful, and the patient has remained alive without disease for 10 months postoperatively.
September 15th, 2006. Chemotherapy in malignant pleural mesothelioma
Results: Polichemotherapy was administered to 16 patients (15 men, 1 woman) with mean age of 61.4 (44-76) years. Thirteen patients had an initial PS=0/1; ten patients had professional contact with products presumably containing asbestos; histology results identified epithelial-type in 14 patients and mixed-type in 2; all patients were in stages III or IV; diagnosis was made by VATS in 14 patients, blind pleural biopsy in 1 patient and guided transthoracic biopsy in 1 patient. Thirteen patients had palliative radiotherapy over the area submitted to specimen collection. We obtained partial responses in 4 patients (25%), stability in 6 (37.5%) and progression in 6 (37.5%). Mean number of chemotherapy sessions was 4.5. To date (September, 2005) 15 patients have died. Mean length to progression was 6.4 months (2-14) and survival 13.8 months (4-29). We observed 7 cases of neutropenia (grades 3 and 4), 2 of which were febrile neutropenia with hospital admission. Reflection: Our results regarding this rare pathology were similar to those found in the literature. It would be interesting to collect national data from all units that treat or have treated MPM; a clinical study comparing the actual chemotherapy regimen to one of those used previously would be another interesting approach to this pathology.
September 15th, 2006. Malignant pleural mesothelioma (MPM) – 5 years of experience
Discussion: S rarely is the treatment of choice, once most of the patients have local advanced disease, old age and comorbilities. The epithelium mesothelioma was the prevalent histological type and because of the few number of patients with other types, it was not possible to establish significant relationships between the histological type and the overall survival. The survival tends to increase, 3 patients were treated with second line Ct and 1 with third line Ct.
September 15th, 2006. Malignant mesothelioma: A ten years experience
Discussion: As demonstrated by the small series in ten years, malignant mesothelioma is a rare tumour. Relationship with asbestos exposure was proven in 67% of cases. Chemotherapy associated with talc pleurodesis increased survival and palliated symptoms.
July 11th, 2006. Divided dose of cisplatin combined with gemcitabine in malignant mesothelioma
There was no treatment related death. Divided dose of cisplatin combined with gemcitabine, at the current dosage and schedule, appears to be an active regimen in chemotherapy-naive patients with malignant mesothelioma, and well-tolerated.
June 30th, 2006. Clinical studies of pemetrexed and gemcitabine combinations
This combination has been, and continues to be evaluated for the treatment of a number of malignancies, including non-small cell lung and ovarian cancer. A recently published randomized trial of different sequences has identified the sequence of pemetrexed on day 1 followed by gemcitabine on day 1 and gemcitabine on day 8, every 21 days as the most efficacious and least toxic sequence.
Conclusions: DCE-MRI can be used in patients with MPM to assess tumor microvascular properties and to demonstrate tumor heterogeneity for therapy monitoring. High pretherapeutic values of kep within the tumor correlated with a poor overall response to therapy.
March 16th, 2006. Novel orthotopic implantation model of human malignant pleural mesothelioma (EHMES-10 cells) highly expressing vascular endothelial growth factor and its receptor
Treatment with cisplatin, but not gemcitabine, significantly inhibited the production of pleural effusions, but it was not effective for thoracic tumors, consistent with chemotherapy refractory characteristics of MPM in patients. Our patient-like orthotopic model using EHMES-10 cells overexpressing VEGF and its receptor may be useful for examining the molecular pathogenesis of MPM and may contribute to the development of novel treatment strategies for MPM.
Conclusion: This phase II study with the sequential approach of two active regimens showed a good disease control in MPM, with symptom improvement and only mild toxicity.
March 13th, 2006. Triplet Chemotherapy for Malignant Pericardial Mesothelioma: A Case Report
The patient experienced no severe non-hematological or hematological toxicities except for grade 3 neutropenia. The patient has returned to her usual activities and has remained well for 24 months after the last chemotherapy without any evidence of disease progression.
February 8th, 2006. Epidemiologic surveillance for primary prevention of malignant mesothelioma: the Italian experience
Conclusions: Despite some ReNam's limitations, identification of MM cases and analysis of modality of exposure, with standardized criteria, are a fundamental tool for primary prevention of asbestos related diseases.
December 21st, 2005. Chemotherapy in malignant pleural mesothelioma
Results: Polichemotherapy was administered to 16 patients (15 men, 1 woman) with mean age of 61.4 (44-76) years. Thirteen patients had an initial PS=0/1; ten patients had professional contact with products presumably containing asbestos; histology results identified epithelial-type in 14 patients and mixed-type in 2; all patients were in stages III or IV; diagnosis was made by VATS in 14 patients, blind pleural biopsy in 1 patient and guided transthoracic biopsy in 1 patient. Thirteen patients had palliative radiotherapy over the area submitted to specimen collection. We obtained partial responses in 4 patients (25%), stability in 6 (37.5%) and progression in 6 (37.5%). Mean number of chemotherapy sessions was 4.5. To date (September, 2005) 15 patients have died. Mean length to progression was 6.4 months (2-14) and survival 13.8 months (4-29). We observed 7 cases of neutropenia (grades 3 and 4), 2 of which were febrile neutropenia with hospital admission. Reflection: Our results regarding this rare pathology were similar to those found in the literature. It would be interesting to collect national data from all units that treat or have treated MPM; a clinical study comparing the actual chemotherapy regimen to one of those used previously would be another interesting approach to this pathology.
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