To compare efficacy and safety of cisplatin-pemetrexed and cisplatin-raltitrexed in the treatment of advanced pleural mesothelioma.
An indirect comparison of efficacy and safety of cisplatin-pemetrexed and cisplatin-raltitrexed was performed. The indirect comparison and the network meta-analysis were performed on data extracted from cisplatin-pemetrexed vs cisplatin, and cisplatin-raltitrexed vs cisplatin comparisons in the treatment of metastatic pleural mesothelioma. The Odds Ratios of 10, 15, and 20 month survival rate and response rate were assumed as indexes of efficacy; the Odds Ratio of grade III-IV side effects, and the absolute risk of overall, hematologic and non-hematologic toxicity, were assumed as indexes of safety.
The outcome of 352 patients were analyzed. 226 patients were treated with cisplatin-pemetrexed and 126 with cisplatin-raltitrexed. The Odds Ratios and 95% Confidence Interval (95% CI) of 10, 15, and 20 months survival rate and response rate were 1.204 (95% CI 0.646-2.244, p = 0.559), 1.022 (95% CI 0.492-2.123, p = 0.953), 1.127 (95% CI 0.437-2.907, p = 0.805) and 0.559 (95% CI 0.258-1.212, p = 0.141), respectively. An absolute increased risk of grade III-IV side effects was observed for cisplatin-pemetrexed: 5.8% (95% CI 2.6%-9%, p
Cisplatin-pemetrexed and cisplatin-raltitrexed can be considered comparable in terms of efficacy in the treatment of metastatic pleural mesothelioma, with a modest increased risk of grade III-IV side effects for cisplatin-pemetrexed. The comparability in terms of efficacy and safety of the two schedules may support clinicians in decision making at the time of planning strategies against metastatic pleural mesothelioma.
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All authors have declared no conflicts of interest.