212P - 2nd line chemotherapy in malignant mesothelioma: A center's experience

Date 15 April 2016
Event European Lung Cancer Conference 2016 (ELCC) 2016
Session Poster lunch
Topics Anticancer agents
Mesothelioma
Therapy
Biological Therapy
Presenter Dimitrios Vassos
Citation Journal of Thoracic Oncology (2016) 11 (supplement 4): S57-S166. S1556-0864(16)X0004-4
Authors D. Vassos1, G. Tsironis2, A. Kopitopoulou1, S. Tsagkouli1, S. Tsimpoukis1, A. Charpidou1, A. Bamias2, K. Syrigos1
  • 1Oncology Unit, 3rd Department Of Medicine, University of Athens, “Sotiria” General Chest Diseases Hospital, 11527 - Athens/GR
  • 2Clinical Therapeutics, Alexandra Hospital, 115 28 - Athens/GR

Abstract

Background

The platinum–pemetrexed doublet is the gold standard in 1st line chemotherapy for Malignant Mesothelioma patients. Since almost all mesothelioma patients will relapse, the choice of second line chemotherapy is important in clinical practice.

Methods

This is a retrospective analysis of 98 patients diagnosed with malignant mesothelioma and treated with chemotherapy at our center. In these patients, we documented demographics, asbestos exposure, histological subtype, involvement of pleura or peritoneum, Eastern Cooperative Oncology Group Performance Status (PS), chemotherapy lines and agents, cycles of chemotherapy received and date of death. For the patients who received 2nd line treatment we additionally documented PS at the initiation of 2nd line treatment, best response by RECIST 1.1 criteria and we calculated Overall Survival (OS) from diagnosis, survival from initiation of 2nd line therapy and Progression Free Survival (PFS) after 2nd line therapy.

Results

50 patients received 2nd line treatment. 48% of these patients received a taxane–gemcitabine doublet resulting in 0% Partial Response (PR), 21.74% Stable Disease (SD) and 69.57% Progressive Disease (PD). Patients had a 2.98 months median Progression Free Survival (mPFS), 15.34 months median Overall Survival (mOS) and 5.88 months survival from the initiation of 2nd line therapy. 18% of the 2nd line setting patients received docetaxel monotherapy. There were 0% PR, 0% SD and 55.56% PD. 22.22% discontinued due to toxicity and 11.11% due to deteriorating Performance Status. mPFS was 3.02 months, 22.96 months mOS and 5.48 months survival from the initiation of 2nd line therapy. Finally 8 patients received the third most common 2nd line option, rechallenge with either the platinum–pemetrexed doublet (n = 6) or pemetrexed monotherapy (n = 2). 14.29% of them demonstrated PR, 57.14% SD and 28.57% PD. mPFS was 7.35 months, mOS 29.20 months and 11.13 months survival from the initiation of 2nd line therapy.

Conclusions

The heterogeneity of the three distinctive 2nd line chemotherapy groups have a negative impact in the reproducibility and interpretation of the results. This study concurs with the literature in that until today no satisfactory 2nd line chemotherapy agent exists for patients with mesothelioma.

Legal entity responsible for the study

University of Athens

Funding

University of Athens

Disclosure

All authors have declared no conflicts of interest.