Department of Medical Oncology, Kinki University School of Medicine, 377-2 Ohno-higashi, Osaka-Sayama, Osaka, 589-8511, Japan.
Int J Clin Oncol. 2010 Oct;15(5):497-9. doi: 10.1007/s10147-010-0064-7. Epub 2010 Mar 12.
Combination chemotherapy with cisplatin and pemetrexed is the most active first-line regimen for malignant pleural mesothelioma (MPM). However, no drugs have been approved for second-line treatment of MPM, with effective regimens remaining to be identified for patients in relapse. We have now evaluated the combination of cisplatin and pemetrexed for retreatment of patients with recurrent MPM. Four men with MPM, all of whom received initial treatment with cisplatin and pemetrexed, underwent retreatment with this drug combination. Two of the patients achieved an objective response to the first-line chemotherapy with no evidence of disease progression for 6.4 or 11.4 months, respectively. The other two patients had stable disease with a duration of 7.8 or 5.0 months, respectively. The two patients who showed an objective response to first-line chemotherapy showed a partial response to retreatment, with a time to progression of 5.0 or 8.2 months, whereas the other two patients had progressive disease with a time to progression of 1.0 or 1.4 months, respectively. Retreatment with cisplatin plus pemetrexed was generally well tolerated. Retreatment with cisplatin and pemetrexed is a potential therapeutic option for certain patients with recurrent epithelioid MPM, possibly including those who show tumor regression with a time to progression of 6 months or more after the initial chemotherapy. Further studies are warranted to evaluate the efficacy of such retreatment and to clarify the criteria for patient selection.
顺铂和培美曲塞联合化疗是恶性胸膜间皮瘤（MPM）最有效的一线治疗方案。然而，尚无药物被批准用于 MPM 的二线治疗，对于复发的患者，仍需要确定有效的治疗方案。我们现在评估了顺铂和培美曲塞联合用于复发性 MPM 患者的二线治疗。4 名患有 MPM 的男性患者均接受过顺铂和培美曲塞的初始治疗，随后接受了该药物联合治疗。其中 2 名患者对一线化疗有客观反应，疾病无进展分别持续了 6.4 个月和 11.4 个月。另外 2 名患者疾病稳定，持续时间分别为 7.8 个月和 5.0 个月。在一线化疗中表现出客观反应的 2 名患者对二线治疗有部分反应，进展时间分别为 5.0 个月和 8.2 个月，而另外 2 名患者疾病进展，进展时间分别为 1.0 个月和 1.4 个月。顺铂加培美曲塞的二线治疗通常耐受良好。顺铂和培美曲塞的二线治疗可能是某些复发性上皮样 MPM 患者的潜在治疗选择，可能包括那些在初始化疗后 6 个月或更长时间疾病无进展的患者。需要进一步的研究来评估这种二线治疗的疗效，并阐明患者选择的标准。
