M.Sc., VU University Medical Center, Department of Clinical Pharmacology and Pharmacy, De Boelelaan 1117, 1081 HV Amsterdam, the Netherlands.
Anticancer Res. 2013 Sep;33(9):3553-61.
This review aims to provide insight into treatment of malignant pleural mesothelioma (MPM) considering effects on survival, quality of life (QoL) and costs, in order to determine the value of pemetrexed in MPM treatment. Cisplatin in combination with pemetrexed or raltitrexed increased survival in MPM, whereas vinorelbine and gemcitabine have led to good response rates. None of these appear to have any detrimental effect with respect to symptoms and global QoL. The cost-effectiveness of pemetrexed-cisplatin was found to be acceptable in advanced MPM compared with cisplatin, but raltitrexed-cisplatin was found to be a more cost-effective treatment option. This may also apply for gemcitabine and vinorelbine, since in contrast to pemetrexed, both agents can be obtained from generic manufacturers. As yet platinum-doublet therapy is the most effective palliative treatment of MPM. To provide a more cost-effective treatment approach for advanced MPM, further research should include randomized controlled trials comparing the recommended pemetrexed-cisplatin directly with platinum doublets with raltitrexed, gemcitabine, or vinorelbine.
本综述旨在探讨恶性胸膜间皮瘤（MPM）的治疗方法，考虑其对生存、生活质量（QoL）和成本的影响，以确定培美曲塞在 MPM 治疗中的价值。顺铂联合培美曲塞或雷替曲塞可提高 MPM 的生存率，而长春瑞滨和吉西他滨则可带来良好的缓解率。这些药物在症状和总体 QoL 方面似乎都没有任何不利影响。与顺铂相比，培美曲塞-顺铂的成本效益在晚期 MPM 中被认为是可接受的，但雷替曲塞-顺铂被认为是一种更具成本效益的治疗选择。对于吉西他滨和长春瑞滨也是如此，因为与培美曲塞不同，这两种药物都可以从仿制药制造商获得。到目前为止，铂类双重疗法是 MPM 最有效的姑息性治疗方法。为了提供一种更具成本效益的晚期 MPM 治疗方法，进一步的研究应包括比较培美曲塞-顺铂与雷替曲塞、吉西他滨或长春瑞滨的铂类双重疗法的随机对照试验。
