Abstract 1739P
Background
Sarcomatoid pleural mesothelioma (SM) is a rare histological sub-type of mesothelioma associated with poor overall survival (OS). The therapeutical approach is based on systemic chemotherapy (CT), despite a lower chemosensitivity as compared with the epithelioid counterpart.
Methods
In this single-center, retrospective study we evaluated clinicopathological features, frontline treatment and survival outcomes of 63 patients with an ascertained pathological diagnosis of SM treated in our center from 2000 until 2020.
Results
The median age was 71 years (range 45-88), 57 (90%) patients were male. At the time of diagnosis, 52 (83%) patients had an Eastern Cooperative Oncology Group Performance Status (ECOG PS) ≤ 1. Twenty (32%) patients received best supportive care (BSC), 39 (62%) received first-line chemotherapy (CT), 3 (5%) trimodality treatment and 1 (2%) patient underwent surgery only. In the subgroup of patients with first-line CT, 26 (67%) were treated with a platinum-based doublet-CT, while 13 (33%) received single agent CT (mono-CT). Patients treated with CT had a median progression-free survival (PFS) of 2 months (95% confidence interval (CI) 1.24-2.76) and a median OS of 7 months (95% CI 5.26-8.74). Compared with patients with mono-CT, patients receiving doublet-CT had a longer median OS (3 months vs. 8 months, HR 0.42 [95% CI, 0.21-0.85], p=0.009). The median PFS was 3 months for patients receiving doublet-CT and 1 month for patients treated with mono-CT (HR 0.87 [95% CI 0.43-1.74], p=0.63) The median OS of patients receiving BSC was 2 months (95% CI 0.95-3.05). No significant difference in OS was found when comparing mono-CT with BSC (3 vs. 2 months, HR 0.55 [95% CI, 0.26-1.17], p=0.082) and this was consistent in the subgroup of patients aged ≥ 70 years (OS 3 vs. 2 months, HR 0.73 [95% CI 0.3-1.75], p=0.440).
Conclusions
In patients with SM not eligible for frontline platinum-based doublet-CT, treatment with single agent CT should be carefully evaluated, since the survival benefit is unclear.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.