Efficacy and safety of first- or second-line irinotecan, cisplatin, and mitomycin in mesothelioma

Cancer. 2007 Jan 1;109(1):93-9. [Link]

Fennell DA, Steele JP, Shamash J, Evans MT, Wells P, Sheaff MT, Rudd RM, Stebbing J.

Lung and Mesothelioma Unit, Department of Medical Oncology, St Bartholomew’s Hospital, West Smithfield, London, UK.


Background: Malignant pleural mesothelioma (MPM) is a rapidly progressive lethal tumor. Treatment options remain limited and the outcome in recurrent disease is poor.

Methods: A Phase II open-label noncomparative study was conducted to assess the safety and efficacy of the triplet combination irinotecan, cisplatin, and mitomycin-C (IPM) chemotherapy in untreated patients and in those with previous exposure to chemotherapy.

Results: In 62 patients an objective response rate of 25% was observed. In the first-line setting progression-free survival measured 6.4 months (95% confidence interval [CI]: 4.5-7.3) and overall survival was 10.8 months (95% CI: 7.9-13.7). In the second-line setting progression-free survival was 7.3 months (95% CI: 3.4-11.2) and overall survival was also 7.3 months (95% CI: 4.8-9.8). Psychosocial well-being improved during chemotherapy and the main toxicity observed was neutropenia (40%).

Conclusions: IPM appeared to have a reasonable response rate with an acceptable toxicity profile in the first- and second-line treatment of MPM.

Keywords: mesothelioma, irinotecan, cisplatin, mitomycin C, phase II, first-line, recurrence