Combination of cisplatin and lurbinectedin as palliative chemotherapy in progressive malignant pleural mesothelioma: Report of two cases

Our plain-English summary of Combination of cisplatin and lurbinectedin as palliative chemotherapy in progressive malignant pleural mesothelioma: Report of two cases, by Y. Metaxas, R. Cathomas, M. Mark, et al (Lung Cancer, 2016).

The study

• Authors: Y. Metaxas, R. Cathomas, M. Mark, R. von Moos
• Journal: Lung Cancer
• Published: 2016;102:136-138
• Type of article: Case report, Letter
• Cited by: 7 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Malignant mesothelioma is an aggressive disease with dismal prognosis despite multimodal treatment including chemotherapy, surgery and radiotherapy. At progression it is possible to provide systemic second-line treatment but its effects are limited. Herein we report two patient cases with mesothelioma who received second-line chemotherapy with the combination of cisplatin and the novel compound lurbinectedin. The combination showed promising activity in both cases with manageable toxicity. We discuss the results of this regime in the light of historical as well as emerging data in mesothelioma.

Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

In plain English

This is a report of two cases. The authors, from a hospital in Chur, Switzerland, described two men with right-sided, resectable malignant mesothelioma. Both received cisplatin-pemetrexed chemotherapy before surgery. When the disease progressed, both received cisplatin plus the new drug lurbinectedin every 3 weeks for 4 cycles, within a Phase I trial. The article does not describe either man's asbestos exposure. The most common side effects were transient anorexia, taste changes, anemia and low platelets (all grade 2), plus low neutrophil counts (grade 3) and fatigue (grade 3) lasting under 3 days. None counted as dose-limiting. Symptoms improved quickly in both men. Imaging showed partial remission in patient 1 and stable disease in patient 2. The disease progressed again after 5.5 months in patient 1 and 6 months in patient 2. Patient 1 died; patient 2 was alive when the article was written. Overall survival was 22 months for each, still ongoing for patient 2. The authors called their data preliminary. They concluded that the combination appears safe and shows promising efficacy, and that clinical trials of it should be evaluated.

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 of two patients treated within a Phase I trial
• Who was studied: Two male patients with primary resectable, right-sided malignant mesothelioma, both locally advanced (Stage III), whose disease progressed after cisplatin-pemetrexed chemotherapy and surgery. The authors are at Kantonsspital Graubünden, Chur, Switzerland. Treatment dates are not given.
• Exposure: No asbestos exposure is reported for either patient. The treatment studied was second-line cisplatin at 60 mg/m2 plus lurbinectedin at 1.1 mg/m2 (patient 1) or 1.4 mg/m2 (patient 2), given on day 1 every 3 weeks for 4 cycles.
• Main results:
  • In the two patients, the most common side effects were transient anorexia, dysgeusia (taste changes), anemia and thrombocytopenia (all grade 2), neutropenia (grade 3), and fatigue lasting less than 3 days (grade 3).
  • None of these side effects qualified as dose-limiting toxicity.
  • Symptoms improved rapidly in both patients.
  • Imaging showed partial remission in patient 1, with the target lesion shrinking by 35%, and stable disease in patient 2.
  • Time to further progression was 5.5 months for patient 1 and 6 months for patient 2.
  • Patient 1 died. Patient 2 was still alive at the time of writing.
  • Survival after recurrence was 12 months for patient 1 and 9 months, still ongoing, for patient 2. Overall survival was 22 months for each, still ongoing for patient 2.
  • Patient 1 had sarcomatoid-biphasic histology and recurrence-free survival of 2.5 months after first-line treatment. Patient 2 had epithelioid histology and recurrence-free survival of 11 months.
• The authors' conclusion: The authors concluded that cisplatin combined with lurbinectedin appears safe to give in malignant mesothelioma and shows promising efficacy as further palliative treatment, and that clinical trials of this combination should be evaluated.
• Limitations the authors state:
  • The authors describe the data as preliminary and based on two patients.

Topics

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

Medical terms in this study, explained in our Lexicon: Cisplatin, Palliative Care, Chemotherapy, Pleural Mesothelioma, Malignant Mesothelioma, Prognosis, Mesothelioma.

Related studies

• Lurbinectedin as second- or third-line palliative therapy in malignant pleural mesothelioma: an international, multi-centre, single-arm, phase II trial (SAKK 17/16) — Y. Metaxas, M. Früh, et al. (2020)
• A Phase II Trial of First-Line Combination Chemotherapy With Cisplatin, Pemetrexed, and Nivolumab for Unresectable Malignant Pleural Mesothelioma: A Study Protocol — N. Fujimoto, K. Aoe, et al. (2018)
• Nursing considerations for administering pemetrexed (Alimta) in combination with cisplatin for malignant pleural mesothelioma — K.K. Orbaugh (2004)
• Nonselective transarterial chemoperfusion: a palliative treatment for malignant pleural mesothelioma — T.J. Vogl, S. Lindemayr, et al. (2013)
• Combination raltitrexed (Tomudex(R))-oxaliplatin: a step forward in the struggle against mesothelioma? The Institut Gustave Roussy experience with chemotherapy and chemo-immunotherapy in mesothelioma — K. Fizazi, R. Caliandro, et al. (2000)
• Impact of Combination Chemotherapy in Peritoneal Mesothelioma Hyperthermic Intraperitoneal Chemotherapy (HIPEC): The RENAPE Study — B. Malgras, E. Gayat, et al. (2018)

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