Fausto Petrelli1, Raffaele Ardito2, Barbara Conti3, Andrea Coinu4, Mary Cabiddu5, Mara Ghilardi5, Karen Borgonovo5, Sandro Barni5, Antonio Ghidini6. 1. Oncology Unit, Oncology Department, ASST Bergamo Ovest, Treviglio, BG, Italy. Electronic address: faupe@libero.it. 2. IRCCS Centro di Riferimento Oncologico della Basilicata (CROB), Via Padre Pio 1, 85028, Rionero in Vulture, PZ, Italy. 3. Surgical Oncology Unit, Surgery Department, ASST Bergamo Ovest, Treviglio, BG, Italy. 4. Oncologia, Ospedale San Francesco, ASSL Nuoro, ATS Sardegna, Via Mannironi, Nuoro, Italy. 5. Oncology Unit, Oncology Department, ASST Bergamo Ovest, Treviglio, BG, Italy. 6. Casa di cura Igea, Oncology Unit, Via Marcona 69, 20144, Milano, Italy.
Abstract
INTRODUCTION: Advanced malignant pleural mesothelioma (MPM) is generally treated with platinum/pemetrexed-based first-line therapy. Once the disease progresses, evidence for the efficacy of palliative treatments is lacking, and platinum re-challenge or single-agent chemotherapy are commonly used. To assess the effects of cytostatic or targeted therapy for treating MPM, we performed a systematic review and meta-analysis. MATERIAL AND METHODS: PubMed, the Cochrane Library, and Embase databases were searched to identify published articles on second-line treatments for recurrent or advanced mesothelioma. Inclusion criteria were publication in the English language, describing clinical trials with 20 or more patients, and evaluability for efficacy and for receiving second-line systemic therapies. Data were pooled using number of events/number of evaluable patients, median overall survival (OS) and progression-free survival (PFS), according to a fixed or random effect model. Pooled median OS was the primary endpoint. RESULTS: A total of 49 eligible studies (n = 3938 patients; range, 12-400) were identified. Median progression-free survival (PFS) was 3.4 months (95%CI 2.87-3.93). Median pooled OS was 7.86 (95%CI 7.01-8.72). The pooled overall response rate (ORR) was 8.63% (95%CI 6-11.26), and the pooled disease control rate (DCR) was 54.8% (95%CI 48.9-60.6). Median pooled OS with platinum- and pemetrexed-based chemotherapy were 7.93 and 7.78 months, respectively. CONCLUSIONS: There remains uncertainty about the ideal second-line agent for MPM. Based on this meta-analysis, palliative chemotherapy or other experimental agents can be considered for patients with MPM who desire further treatment after their disease has progressed, during or after first-line therapy.
INTRODUCTION: Advanced malignant pleural mesothelioma (MPM) is generally treated with platinum/pemetrexed-based first-line therapy. Once the disease progresses, evidence for the efficacy of palliative treatments is lacking, and platinum re-challenge or single-agent chemotherapy are commonly used. To assess the effects of cytostatic or targeted therapy for treating MPM, we performed a systematic review and meta-analysis. MATERIAL AND METHODS: PubMed, the Cochrane Library, and Embase databases were searched to identify published articles on second-line treatments for recurrent or advanced mesothelioma. Inclusion criteria were publication in the English language, describing clinical trials with 20 or more patients, and evaluability for efficacy and for receiving second-line systemic therapies. Data were pooled using number of events/number of evaluable patients, median overall survival (OS) and progression-free survival (PFS), according to a fixed or random effect model. Pooled median OS was the primary endpoint. RESULTS: A total of 49 eligible studies (n = 3938 patients; range, 12-400) were identified. Median progression-free survival (PFS) was 3.4 months (95%CI 2.87-3.93). Median pooled OS was 7.86 (95%CI 7.01-8.72). The pooled overall response rate (ORR) was 8.63% (95%CI 6-11.26), and the pooled disease control rate (DCR) was 54.8% (95%CI 48.9-60.6). Median pooled OS with platinum- and pemetrexed-based chemotherapy were 7.93 and 7.78 months, respectively. CONCLUSIONS: There remains uncertainty about the ideal second-line agent for MPM. Based on this meta-analysis, palliative chemotherapy or other experimental agents can be considered for patients with MPM who desire further treatment after their disease has progressed, during or after first-line therapy.
Authors: Arkadiusz Z Dudek; Xiaofei Wang; Lin Gu; Stephanie Duong; Thomas E Stinchcombe; Robert Kratzke; Hossein Borghaei; Everett E Vokes; Hedy L Kindler Journal: Clin Lung Cancer Date: 2020-07-03 Impact factor: 4.785
Authors: Yurong Song; Shaneen S Baxter; Lisheng Dai; Chelsea Sanders; Sandra Burkett; Ryan N Baugher; Stephanie D Mellott; Todd B Young; Heidi E Lawhorn; Simone Difilippantonio; Baktiar Karim; Yuwaraj Kadariya; Ligia A Pinto; Joseph R Testa; Robert H Shoemaker Journal: Cancers (Basel) Date: 2022-06-24 Impact factor: 6.575
Authors: Alberto M Marchevsky; Andras Khoor; Ann E Walts; Andrew G Nicholson; Yu Zhi Zhang; Victor Roggli; John Carney; Anja C Roden; Henry D Tazelaar; Brandon T Larsen; Nolwenn LeStang; Lucian R Chirieac; Sonja Klebe; Ming-Sound Tsao; Marc De Perrot; Andrew Pierre; David M Hwang; Yin P Hung; Mari Mino-Kenudson; William Travis; Jennifer Sauter; Mary Beth Beasley; Françoise Galateau-Sallé Journal: Mod Pathol Date: 2019-09-04 Impact factor: 7.842