Malignant peritoneal mesothelioma in a child: chemotherapy with gemcitabine and platinum was effective for the disease unresponsive to other treatments

Our plain-English summary of Malignant peritoneal mesothelioma in a child: chemotherapy with gemcitabine and platinum was effective for the disease unresponsive to other treatments, by S. Kobayashi, T. Waragai, H. Sano, et al (Anti-cancer Drugs, 2014).

The study

• Authors: S. Kobayashi, T. Waragai, H. Sano, K. Mochizuki, M. Akaihata, Y. Ohara, M. Hosoya, A. Kikuta
• Journal: Anti-cancer Drugs
• Published: 2014;25(9):1102-5
• Type of article: Case report
• Cited by: 3 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Malignant peritoneal mesothelioma in children is a very rare disease and has a poor prognosis. Unlike malignant mesothelioma in adults, there is no clear causal association between this very rare malignancy in children and asbestos exposure. We report a case of peritoneal mesothelioma in an 11-year-old boy who presented with ascites. He was diagnosed with malignant mesothelioma on the basis of histopathological findings. His disease showed resistance to pemetrexed, but was treated successfully with platinum-based therapy with gemcitabine. He has achieved long-term survival in partial remission with stable disease.

In plain English

This article was a case report from Fukushima Medical University in Japan about one 11-year-old boy with malignant peritoneal mesothelioma, a cancer of the lining of the abdomen. He had fever, abdominal pain, poor appetite and a large amount of fluid in the abdomen. The authors reported no previous or family history of asbestos exposure. They wrote that, unlike in adults, there is no clear causal association between this cancer in children and asbestos. A biopsy showed mesothelioma that had spread widely in the abdominal cavity, with no spread to organs. The first treatment, pemetrexed with cisplatin, partly shrank the tumors after three cycles, but the disease progressed after six cycles. A second combination (ICE alternating with VAC) was followed by progression after two cycles. He then received cisplatin with gemcitabine. Cisplatin was later replaced by carboplatin because of reduced kidney function. No major toxicity was seen and the tumor did not progress. At 25 months after diagnosis he was alive with stable remaining disease and attending school. The authors concluded that platinum with gemcitabine showed efficacy against this disease. The report describes one patient only.

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 (one patient)
• Who was studied: One previously healthy 11-year-old boy. The authors are at Fukushima Medical University, Fukushima, Japan. Treatment dates are not given.
• Exposure: No asbestos exposure: the article reports no previous or family history of asbestos exposure. The authors state there is no clear causal association between malignant peritoneal mesothelioma in children and asbestos exposure. The report is about chemotherapy treatments: pemetrexed plus cisplatin; ICE alternating with VAC; and gemcitabine with cisplatin, later with carboplatin.
• Main results:
  • Biopsy of a peritoneal nodule and the omentum showed malignant mesothelioma. The disease had spread widely in the abdominal cavity, but no organ metastases were found.
  • With pemetrexed plus cisplatin, the boy had a partial radiographic response after the first three cycles. CT and PET scans showed progression after six cycles.
  • With ICE alternating with VAC, the tumor progressed after two cycles.
  • With gemcitabine and platinum (cisplatin, changed to carboplatin because of renal insufficiency), no major toxicity was observed and PET scans showed the tumor did not progress.
  • At 25 months after diagnosis, the boy was alive with stable residual disease and good performance status, and was attending school. At two years after diagnosis and 14 months after starting gemcitabine, the authors described him as in partial remission with stable disease.
• The authors' conclusion: The authors concluded that platinum with gemcitabine showed efficacy in this case. They suggested that, when pemetrexed plus cisplatin as first-line treatment is not effective, gemcitabine plus cisplatin should be considered as second-line treatment for malignant peritoneal mesothelioma.

Topics

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

Medical terms in this study, explained in our Lexicon: Peritoneal Mesothelioma, Chemotherapy, Gemcitabine, Prognosis, Malignant Mesothelioma, Asbestos Exposure, Ascites, Pemetrexed (Alimta).

Related studies

• The efficacy of the frontline platinum-based combination chemotherapy in malignant peritoneal mesothelioma — S.T. Kim, J.Y. Park, et al. (2010)
• Gemcitabine and vinorelbine as second-line or beyond treatment in patients with malignant pleural mesothelioma pretreated with platinum plus pemetrexed chemotherapy — G. Toyokawa, M. Takenoyama, et al. (2014)
• DNA repair polymorphisms and treatment outcomes of patients with malignant mesothelioma treated with gemcitabine-platinum combination chemotherapy — N. Erčulj, V. Kovač, et al. (2012)
• Comparison of cisplatin plus pemetrexed and cisplatin plus gemcitabine for the treatment of malignant pleural mesothelioma in Japanese patients — T. Shukuya, T. Takahashi, et al. (2014)
• The effectiveness and safety of platinum-based pemetrexed and platinum-based gemcitabine treatment in patients with malignant pleural mesothelioma — G. Ak, S. Metintas, et al. (2015)
• Importance of excision repair cross-complementation group 1 and ribonucleotide reductase M1 as prognostic biomarkers in malignant pleural mesothelioma treated with platinum-based induction chemotherapy followed by surgery — L. Frischknecht, M. Meerang, et al. (2015)

Browse more research in Anti-cancer Drugs, or return to medical research.