Chemotherapy of malignant diffuse mesothelioma.

The clinicopathologic features of six pleural and one peritoneal mesothelioma were analyzed. Six patients were treated with either adriamycin or a multiple drug regimen consisting of cyclophosphamide, vincristine, methotrexate, and 5-fluorouracil (COMF). Of those who received COMF, one obtained a complete response lasting 19 months and two had partial responses lasting 3 and 7 months. Adriamycin was administered to five patients. Two obtained a complete response lasting 19 and 7 months. Three had partial responses lasting 2, 6, and 9 months. Grading of response was often difficult requiring serial review of chest x-rays. Survival from diagnosis ranged from 2 to 39 months, with a median of 9 months. We conclude that adriamycin or COMF treatment may offer worthwhile remissions in mesothelioma and that malignant diffuse mesothelioma is more responsive to chemotherapy than previously realized.