High liposomal doxorubicin tumour tissue distribution, as determined by radiopharmaceutical labelling with (99m)Tc-LD, is associated with the response and survival of patients with unresectable pleural mesothelioma treated with a combination of liposomal doxorubicin and cisplatin

Our plain-English summary of High liposomal doxorubicin tumour tissue distribution, as determined by radiopharmaceutical labelling with (99m)Tc-LD, is associated with the response and survival of patients with unresectable pleural mesothelioma treated with a combination of liposomal doxorubicin and cisplatin, by O. Arrieta, L.A. Medina, E. Estrada-Lobato, et al (Cancer Chemotherapy and Pharmacology, 2014).

The study

• Authors: O. Arrieta, L.A. Medina, E. Estrada-Lobato, L.A. Ramírez-Tirado, V.O. Mendoza-García, J. de la Garza-Salazar
• Journal: Cancer Chemotherapy and Pharmacology
• Published: 2014;74(1):211-5
• Cited by: 43 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Background: There are currently no available biomarkers for advanced pleural mesothelioma that determine which patients could benefit from a specific chemotherapy regimen.

Methods: Based on the results of a previously published phase II study, we associated the (99m)Technetium-labelled liposomal doxorubicin ((99m)Tc-LD) uptake value (75 % cut-off) with the response rate, progression-free survival and overall survival of patients treated with a combination of liposomal doxorubicin and cisplatin.

Results: Patients with tumours exhibiting increased (99m)Tc-LD uptake showed better response rates, progression-free survival and overall survival than those exhibiting lower uptake 73.3 versus 15 % (p < 0.001); 6.9 versus 3.2 months (p = 0.033) and 23 versus 6.6 months (p = 0.001), respectively.

Conclusion: (99m)Tc-DL uptake in tumour tissue could define a set of patients who would benefit from this chemotherapy regimen.

In plain English

This short communication reported a further analysis of a previously published phase II trial at the Instituto Nacional de Cancerología in Mexico City. It included 35 patients with advanced, unresectable malignant pleural mesothelioma treated with liposomal doxorubicin plus cisplatin. Forty percent had a known exposure to asbestos. In the first cycle, the drug was labelled with a radioactive tracer (technetium-99m) to measure how much reached the tumour. Patients were divided at an uptake index of 75%. Among the 15 patients with uptake of 75% or more, 11 (73.3%) had a partial response, compared with 3 of 20 (15%) with lower uptake. For the higher and lower uptake groups, progression-free survival was 6.9 months (95% CI 4.4 to 9.3) versus 3.2 months (1.7 to 4.7), and overall survival was 23 months (19 to 27.2) versus 6.6 months (4.4 to 8.8). Average uptake did not differ significantly between patients with and without asbestos exposure. The authors concluded that tracer uptake in the tumour could identify patients who would benefit from this chemotherapy combination. They noted the small sample size and called for further study.

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: Short communication: secondary analysis of patients from the authors' previously published phase II chemotherapy trial, relating tumour uptake of radiolabelled liposomal doxorubicin to treatment response and survival
• Who was studied: 35 patients with advanced (stage III/IV), unresectable malignant pleural mesothelioma with evaluable response, treated at the Instituto Nacional de Cancerología, Mexico City. They were 74% male, with a mean age of 60.1 years and 71% epithelioid histology; 40% had a known asbestos exposure. Survival was followed up through November 2013.
• Exposure: Chemotherapy with liposomal doxorubicin 40 mg/m2 plus cisplatin 60 mg/m2 every 21 days, for up to six cycles. In the first cycle, technetium-99m-labelled liposomal doxorubicin was given to measure drug uptake in the tumour, and patients were split into higher and lower uptake groups at a 75% cut-off. Asbestos exposure was recorded only as a patient characteristic.
• Main results:
  • Across all 35 patients, 40% (14/35) had a partial response, 20% (7/35) had stable disease and 40% (14/35) had disease progression. There were no complete responses.
  • Response rate was 73.3% (11/15) in patients with uptake of 75% or more versus 15% (3/20) in patients with uptake below 75% (p less than 0.001)
  • Patients who responded had higher mean uptake than non-responders (78.4 plus or minus 12 vs 62.4 plus or minus 15, p = 0.002)
  • Progression-free survival was 6.9 months (95% CI 4.4 to 9.3) in the higher-uptake group versus 3.2 months (95% CI 1.7 to 4.7) in the lower-uptake group (p = 0.033)
  • Overall survival was 23 months (95% CI 19 to 27.2) in the higher-uptake group versus 6.6 months (95% CI 4.4 to 8.8) in the lower-uptake group (p = 0.001)
  • Mean uptake did not differ by gender, age, smoking, asbestos exposure, stage or histology. Asbestos-exposed patients (n = 14) had a mean uptake of 73 plus or minus 10.5 versus 66 plus or minus 18.3 in unexposed patients (n = 21), p = 0.161.
• The authors' conclusion: The authors concluded that uptake of radiolabelled liposomal doxorubicin in tumour tissue could define a set of patients who would benefit from the liposomal doxorubicin plus cisplatin regimen
• Limitations the authors state:
  • The authors noted the small sample size and the nature of the study, and stated that further investigation is warranted

Topics

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

Medical terms in this study, explained in our Lexicon: Doxorubicin, Unresectable Pleural Mesothelioma, Cisplatin, Biomarker, Pleural Mesothelioma, Chemotherapy, Progression-Free Survival, Overall Survival.

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