159P - Impact of maintenance pemetrexed in the management of non-progressing malignant mesotheliomas after standard fist-line chemotherapy: A single instit...

Date 17 April 2015
Event ELCC 2015
Session Poster lunch
Topics Anti-Cancer Agents & Biologic Therapy
Presenter Tindara Franchina
Citation Annals of Oncology (2015) 26 (suppl_1): 48-50. 10.1093/annonc/mdv052
Authors T. Franchina1, A. Russo2, A. Picone2, G.R.R. Ricciardi1, F. Raiti2, A. Scimone2, G. Chiofalo2, G. Toscano2, V. Adamo2
  • 1Department Of Human Pathology University Of Messina, Medical Oncology Unit AOOR Papardo-Piemonte, 98158 - Messina/IT
  • 2Department Of Human Pathology University Of Messina, Medical Oncology Unit AOOR Papardo-Piemonte, Messina/IT



Malignant mesothelioma (MM) is rare disease entity that could involve pleura (MPM) or peritoneum (MPeP). Pemetrexed (P) combined with Cisplatin is the standard first-line chemotherapy for advanced unresectable MM, with Carboplatin reserved those who are not candidates for Cisplatin-based therapy. However, the optimal treatment duration is still debated. The purpose of our study was to retrospectively evaluate the impact on time to progression (TTP) of P maintenance in non-progressing MM patients (pts) after six courses of P-containing induction chemotherapy.


We collected and retrospectively analyzed data of 19 advanced MM patients, consecutively treated at our institution with P-based first-line chemotherapy from 2010 to 2013. A statistical analysis was performed with SPSS 19.0 software. P-values <0.05 was considered statistically significant.


In our case series 16 pts had MPM and 3 MPeM. Epithelial was the major tumor subtype. Median age at diagnosis was 64 (range 37-76 years). ECOG PS was 0-2. All pts received P-based chemotherapy in first-line: Cisplatin was used in six patients, Carboplatin in 13 pts. After induction P, six patients progressed, two pts obtained a PR, ten achieved a stable disease. Six pts received P monotherapy as maintenance after 6 courses of platinum doublets. No pts received P re-challenge. TTP in overall population was 6.2 months. P-maintenance significantly prolonged TTP compared with post treatment observation: 9.7 months (range 6-14 months) versus 4.6 months (range 2-13 months) respectively (P = 0.027). Adverse events were mostly of grade 1-2.


Maintenance therapy with Pemetrexed in MPM is a feasible therapeutic option in non-progressing MM patients after fist-line standard chemotherapy, with a good toxicity profile. TTP results in the overall populations are in line with data reported in the pivotal trial (6.2 months vs. 5.7 months). In the small subset of pts receiving P-maintenance TTP was significantly longer. However, further prospective studies should confirm these results and compare this strategy with Pemetrexed re-challenge after disease recurrence.


All authors have declared no conflicts of interest.