165P - Malignant pleural mesothelioma: A systematic review of first-line chemotherapy and analysis of Hong Kong cohort

Date 07 May 2017
Event ELCC 2017
Session Poster Display Session
Topics Mesothelioma
Thoracic malignancies
Presenter Herbert Pang
Citation Annals of Oncology (2017) 28 (suppl_2): ii56-ii58. 10.1093/annonc/mdx093
Authors H. Pang1, J. Ji1, K. Yan1, C.C. Leung2, D. Lam3
  • 1School Of Public Health, Li Ka Shing Faculty Of Medicine, The University of Hong Kong, NA - Hong Kong/CN
  • 2Centre For Health Protection, Department of Health, Hong Kong/CN
  • 3Department Of Medicine, Li Ka Shing Faculty Of Medicine, The University of Hong Kong, Hong Kong/CN

Abstract

Background

Malignant pleural mesothelioma (MPM) is a rare but aggressive cancer. Although the standard first-line chemotherapy for MPM has been established, many different treatments are still under investigation. Additionally, epidemiologic analysis of MPM patients in Hong Kong has not been conducted in recent years.

Methods

To review the progress in first-line chemotherapy treatment for MPM patients between 2010 and 2016, and to study the epidemiology and prognostic factors of Hong Kong MPM patients from 2002 to 2015. A thorough literature search was performed on PubMed and Cochrane Library (CENTRAL), restricted to English papers released between January 2010 and May 2016. Hong Kong MPM patients were identified from Pneumoconiosis Medical Board (PMB) by reviewing medical records. Kaplan-Meier and log-rank tests were used to compare survival between categories. Prognostic factors were identified by Cox regression analysis.

Results

22 studies were included in the review. Pemetrexed/cisplatin is the recommended first-line regime now. Studies suggested that carboplatin plus pemetrexed can be an alternative regimen to reduce toxicity. The addition of bevacizumab to pemetrexed/cisplatin showed promising results and may become a new paradigm. Gemcitabine plus cisplatin, especially administrated in low dose prolonged infusion, showed comparable efficacy with lower cost. From the Hong Kong PMB clinic, 102 MPM patients were identified, with male predominance, mean age of 69.1 years at diagnosis, mean latency of 49 years, median overall survival of 11.7 months and mainly epithelioid histological subtype. Other possible prognostic factors like symptoms of chest pain and dyspnea were explored.

Conclusions

Cisplatin plus pemetrexed, has been supported in routine practices settings. Carboplatin can substitute cisplatin to reduce toxicity. Bevacizumab plus cisplatin-pemetrexed triplet with appropriate management of treatment-related toxicity is the most promising first-line treatment. Hong Kong MPM patients share similarities in terms of prognostic factors with those in the literature.

Clinical trial identification

Legal entity responsible for the study

HKU

Funding

Pneumoconiosis Compensation Fund Board

Disclosure

All authors have declared no conflicts of interest.