BMC Res Notes. 2012 Sep 3;5(1):482.

Re-challenge with pemetrexed in advanced mesothelioma: a multi-institutional experience.

Bearz A, Talamini R, Rossoni G, Santo A, de Pangher V, Fasola G, Rosetti F, Favaretto A, Gregorc V, Berretta M, Santarossa S, Berto E, Tirelli U.
Abstract

ABSTRACT: BACKGROUND: Although first-line therapy for patients affected by advanced mesothelioma is well established, there is a lack of data regarding the impact of second-line treatment.

METHODS: We retrospectively collected data of patients affected by advanced mesothelioma, already treated with first-line therapy based on pemetrexed and platin, with a response (partial response or stable disease) lasting at least 6 months, and re-treated with a pemetrexed-based therapy at progression. The primary objective was to describe time to progression and overall survival after re-treatment.

RESULTS: Overall across several Italian oncological Institutions we found 30 patients affected by advanced mesothelioma, in progression after a 6-month lasting clinical benefit following a first-line treatment with cisplatin and pemetrexed, and re-challenged with a pemetrexed-based therapy. In these patients we found a disease control rate of 66%, with reduction of pain in 43% of patients. Overall time to progression and survival were promising for a second-line setting of patients with advanced mesothelioma, being 5.1 and 13.6 months, respectively.

CONCLUSIONS: In our opinion, when a patient experience a long-lasting benefit from previous treatment with pemetrexed combined with a platin compound, the same treatment should be offered at progression.

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