Chemotherapy maintenance: an option for prolonged survival in malignant peritoneal mesothelioma?

Our plain-English summary of Chemotherapy maintenance: an option for prolonged survival in malignant peritoneal mesothelioma?, by S. Hofer, B. Sasse, H. Scheffel (Acta Oncologica, 2010).

The study

• Authors: S. Hofer, B. Sasse, H. Scheffel
• Journal: Acta Oncologica
• Published: 2010;49(1):122-4
• Type of article: Case report
• Read it: PubMed · Publisher

In plain English

This letter to the editor described a single patient, treated by doctors at University Hospital Zürich: a 48-year-old with malignant peritoneal mesothelioma (cancer of the lining of the abdomen) diagnosed five years earlier. At diagnosis the patient had bulky disease and fluid in the abdomen (ascites). A biopsy showed the epitheloid type of mesothelioma, with a low proliferation rate (10%). The authors wrote that the disease was thought to result from abdominal radiation given 30 years earlier for Hodgkin's disease. The article does not discuss asbestos exposure. The patient received pemetrexed and carboplatin every three weeks for one year, then pemetrexed alone. A CT scan 2¾ years after chemotherapy began showed an almost complete response. Maintenance pemetrexed was still ongoing five years after diagnosis, and quality of life was reported as without restrictions. The authors noted that the favourable tissue type may explain the long survival without progression, and that CT and FDG-PET scans are not reliable for detecting small tumor growth. Based on this case and two other case reports, the authors hypothesized that maintenance pemetrexed may improve outcome in a subgroup of patients with favourable disease that responds to treatment at first.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Case report (letter to the editor) describing one patient
• Who was studied: One 48-year-old patient with malignant peritoneal mesothelioma, epitheloid variant, diagnosed five years before the report, who had bulky disease and ascites at diagnosis
• Exposure: The exposure studied was chemotherapy: pemetrexed plus carboplatin every three weeks for one year, followed by pemetrexed alone as maintenance therapy. The authors attributed the mesothelioma to abdominal irradiation 30 years earlier for Hodgkin's disease. Asbestos exposure is not discussed.
• Main results:
  • At diagnosis the patient had bulky disease and ascites
  • The biopsy showed an epitheloid malignant peritoneal mesothelioma with a low proliferation rate (10%)
  • In this patient, an almost complete response on CT scan was documented 2¾ years after chemotherapy was first given
  • In this patient, maintenance pemetrexed was still ongoing five years after diagnosis, and quality of life was without any restrictions
• The authors' conclusion: The authors hypothesized, based on this case and two other case reports, that maintenance therapy with pemetrexed may improve outcome in a subgroup of patients with favourable malignant peritoneal mesothelioma that is initially responsive to treatment.
• Limitations the authors state:
  • The patient's favourable tissue type (histology) may explain the prolonged survival without progression
  • CT scan and FDG-PET are not reliable for detecting small (non-bulky) tumor growth in the peritoneum, so a complete remission is hard to confirm
  • Methods for monitoring remaining disease, and rules for when to stop maintenance therapy, are lacking

Topics

The National Library of Medicine indexes this study under subjects our site covers: Mesothelioma, Peritoneal mesothelioma.

Medical terms in this study, explained in our Lexicon: Chemotherapy, Peritoneal Mesothelioma.

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