Shao Keda, Wu Di, Wang Qian, Wang Dong, Hao Yue, Li Bihui, Huang Jianhui, Yang Ziyan, Wu Jingxun, Huang Long, Li Wenfeng, Meng Rui, Feng Jian, Fu Jianfei, Feng Huijing, Yang Shengjie, Xu Ling, Shi Xuefei, Li Miao, Wang Yujuan, Xu Chunwei, Song Zhengbo
Postgraduate Training Base Alliance of Wenzhou Medical University (Zhejiang Cancer Hospital), Hangzhou, China.
Department of Clinical Trial, Zhejiang Cancer Hospital, Hangzhou Institute of Medicine (HIM), Chinese Academy of Sciences, Hangzhou, China.
J Thorac Dis. 2025 Aug 31;17(8):5687-5697. doi: 10.21037/jtd-2025-566. Epub 2025 Aug 28.
Malignant pleural mesothelioma (MPM) is a highly aggressive malignancy with a poor prognosis. While pemetrexed-based chemotherapy and dual immunotherapy are established first-line treatments, optimal second- and later-line therapies remain underexplored. This study aims to evaluate later-line treatment options for MPM.
We retrospectively evaluated the outcomes of 85 patients with MPM who had failed in the first-line treatment between 2006 and 2023 in six hospitals. Survival outcomes were analyzed using Kaplan-Meier methodology, with between-group comparisons performed via log-rank testing. The Cox proportional hazards model was employed for both univariate and multivariate analyses to identify prognostic factors. Treatment response was assessed using standard efficacy endpoints: objective response rate (ORR) and disease control rate (DCR).
This retrospective analysis evaluated 85 patients with advanced MPM. The cohort demonstrated a median progression-free survival (PFS) of 3.73 months and a median overall survival (OS) of 12.4 months. In the later-line, combining chemotherapy with anti-vascular therapy showed significant efficacy in median PFS than the chemotherapy scheme (4.57 3.00 months, P=0.004), as well as differences in median OS (13.00 10.03 months, P=0.04).
For patients with MPM requiring later-line treatment, the combination of chemotherapy and anti-vascular therapy may represent a viable therapeutic alternative, demonstrating an acceptable safety profile.
恶性胸膜间皮瘤（MPM）是一种侵袭性很强的恶性肿瘤，预后较差。虽然培美曲塞化疗和双免疫疗法是既定的一线治疗方法，但最佳的二线及后续治疗方案仍未得到充分探索。本研究旨在评估MPM的后续治疗方案。
我们回顾性评估了2006年至2023年间在六家医院一线治疗失败的85例MPM患者的治疗结果。采用Kaplan-Meier方法分析生存结果，通过对数秩检验进行组间比较。采用Cox比例风险模型进行单因素和多因素分析，以确定预后因素。使用标准疗效终点评估治疗反应：客观缓解率（ORR）和疾病控制率（DCR）。
这项回顾性分析评估了85例晚期MPM患者。该队列的中位无进展生存期（PFS）为3.73个月，中位总生存期（OS）为12.4个月。在后续治疗中，化疗联合抗血管生成治疗在中位PFS方面比单纯化疗方案显示出显著疗效（4.57对3.00个月，P=0.004），中位OS也存在差异（13.00对10.03个月，P=0.04）。
对于需要进行后续治疗的MPM患者，化疗联合抗血管生成治疗可能是一种可行的治疗选择，且安全性可接受。
