Abdel-Rahman Omar, Kelany Mohamed
a Clinical Oncology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Expert Rev Respir Med. 2015 Oct;9(5):533-49. doi: 10.1586/17476348.2015.1083426. Epub 2015 Sep 7.
The aim of this systematic review is to assess the evidence for the available 2nd/3rd line systemic therapies for malignant pleural mesothelioma (MPM). Eligible studies were obtained through appropriate databases and meetings abstracts search. A total of 29 studies were considered eligible for this review and it includes three Phase III studies, eighteen phase II studies and eight retrospective studies. For the Phase III studies, none have achieved an overall survival benefit; while for the Phase II studies, the majority have not achieved sufficient satisfactory outcome to justify advancement to Phase III studies. We believe that the best salvage treatment for MPM would be inclusion into appropriately designed clinical trials. In the absence of a clinical trial, gemcitabine and/or vinorelbine-based regimens could be considered. Moreover, pemetrexed re-challenge can be considered in selected pemetrexed-sensitive patients.
本系统评价的目的是评估可用于恶性胸膜间皮瘤（MPM）二线/三线全身治疗的证据。通过检索适当的数据库和会议摘要获取符合条件的研究。共有29项研究被认为符合本评价的条件，其中包括三项III期研究、十八项II期研究和八项回顾性研究。对于III期研究，均未实现总生存获益；而对于II期研究，大多数研究未取得足够令人满意的结果以证明可推进至III期研究。我们认为，MPM的最佳挽救治疗方法是纳入设计合理的临床试验。在没有临床试验的情况下，可以考虑基于吉西他滨和/或长春瑞滨的方案。此外，对于选定的培美曲塞敏感患者，可以考虑再次使用培美曲塞。
