Takeda Takayuki, Itano Hideki, Fukita Shinichi, Saitoh Masahiko, Takeda Sorou
Division of Respiratory Medicine, Department of Internal Medicine, Uji Tokushukai Medical Center, Japan.
Intern Med. 2014;53(20):2347-51. doi: 10.2169/internalmedicine.53.2094. Epub 2014 Oct 15.
Malignant pleural mesothelioma (MPM) is associated with a poor prognosis. The combination of cisplatin and pemetrexed has been established as a standard chemotherapy that confers a survival benefit. Because the regimen is sometimes hampered by the renal toxicity of cisplatin and no second-line chemotherapy has yet been established, the strategy of administering a higher total dose of pemetrexed to optimize the regimen could be promising. We herein describe the case of a 69-year-old man with MPM who underwent five cycles of cisplatin plus pemetrexed and exhibited a partial response. Because his serum creatinine increased, pemetrexed maintenance therapy (PMT) was adopted, and 18 cycles were successfully delivered and the patient achieved a complete response. This case suggests that PMT could thus be useful for treating MPM.
恶性胸膜间皮瘤(MPM)的预后较差。顺铂和培美曲塞联合使用已被确立为一种能带来生存获益的标准化化疗方案。由于该方案有时会受到顺铂肾毒性的影响,且二线化疗方案尚未确立,因此增加培美曲塞总剂量以优化该方案的策略可能很有前景。我们在此报告一例69岁的MPM男性患者,其接受了五个周期的顺铂加培美曲塞治疗并出现部分缓解。由于其血清肌酐升高,故采用培美曲塞维持治疗(PMT),成功进行了18个周期的治疗,患者实现了完全缓解。该病例表明,PMT可能对MPM治疗有用。