Onkológia 6/2011

Chemotherapy for malignant pleural mesothelioma

Several small phase II trials with different agents were done in malignant pleural mesothelioma (MPM) between 1983 and 2001. Based on the metaanalysis of these trials the first reference regiment, combination of doxorubicin and cisplatin, was established. Another regiment, gemcitabine and cisplatin, entered the clinical practice based on the phase II studies data, which suggested at least the same activity as seen with doxorubicin and cisplatin. Results of the first phase III trial in MPM were published in 2003 and led to the new standard for the first line treatment: combination of pemetrexed and cisplatin. The strategies, which might be considered for the second line treatment include: retreatment with pemetrexed, use of cisplatin based combination (cisplatin with gemcitabine), and single drug therapy (vinorelbine or gemcitabine). Several trials with targeted biologic therapies, either as a single drug therapy or in combination with chemotherapy are ongoing.

Keywords: mesothelioma, chemotherapy, cisplatin, pemetrexed.