Oral etoposide in the treatment of malignant mesothelioma. A phase II study

Our plain-English summary of Oral etoposide in the treatment of malignant mesothelioma. A phase II study, by L. Tammilehto, P. Maasilta, M. Mäntylä, et al (Annals of Oncology, 1994).

The study

• Authors: L. Tammilehto, P. Maasilta, M. Mäntylä, J. Salo, K. Mattson
• Journal: Annals of Oncology
• Published: 1994;5(10):949-50
• Cited by: 16 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Summary of the article

This short report described a phase II trial of low-dose oral etoposide in malignant mesothelioma. Between 1990 and 1992, 42 patients at Helsinki University Central Hospital in Finland were diagnosed histologically with malignant mesothelioma. Of these, 23 were entered in the trial. They received daily oral etoposide (100 mg) for 21 days, followed by 2 weeks without treatment. Nineteen patients were evaluable for response. Three were non-evaluable because of previous treatment and one because of a wrong diagnosis. The evaluable patients were 15 men and 4 women with a median age of 63 years (range 44-76). Eleven tumours were epithelial and 8 mixed, and two patients had peritoneal mesothelioma. Asbestos exposure was classed as definite, probable or possible in 14 patients. Tumours were assessed by contrast-enhanced CT before treatment and every 3 months thereafter, and toxicity was graded according to WHO guidelines. Ten patients received 1-3 cycles and 13 (57%) received 4 or more. Thirteen of 122 cycles were reduced because of treatment-related myelosuppression. There were no complete responses and one partial response, lasting 16 months. Disease was stabilised in 15 patients (2-10 months), and 3 had progressive disease. Median survival was 17 months after diagnosis, and 13 of the 23 patients were still alive. The authors concluded that toxicity was acceptable, with no treatment-related deaths. However, etoposide was active against less than 20% of tumours at this dosage, and routine chemotherapy for mesothelioma remained controversial.

PubMed has no abstract for this study, and the article doesn't print one. We wrote this summary from the full article with the help of AI. It is not the authors' wording.

In plain English

This short report described a phase II trial at Helsinki University Central Hospital, Finland, testing low-dose oral etoposide, a chemotherapy drug, in malignant mesothelioma. Of 42 patients diagnosed there between 1990 and 1992, 23 entered the trial, taking 100 mg daily for 21 days followed by 2 weeks without treatment. Nineteen could be assessed for tumour response on CT scans. Of these, 17 had pleural and 2 had peritoneal mesothelioma, and 14 had definite, probable or possible asbestos exposure. There were no complete responses and one partial response, lasting 16 months. Disease was stabilised in 15 patients for 2 to 10 months, and 3 patients developed progressive disease. Median survival was 17 months after diagnosis, and 13 of the 23 patients were still alive. Doses were reduced in 13 of 122 cycles because of low blood counts, and there were no treatment-related deaths. The authors concluded that toxicity was acceptable but that, at this dosage, etoposide was active against less than 20% of tumours, and that routine chemotherapy for mesothelioma must remain controversial.

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: Phase II trial of a single chemotherapy drug (published as a short report)
• Who was studied: 23 of 42 patients diagnosed histologically with malignant mesothelioma at Helsinki University Central Hospital, Finland, between 1990 and 1992. 19 were evaluable for response: 17 with pleural and 2 with peritoneal mesothelioma, 15 male and 4 female, median age 63 (range 44 to 76). Of the 4 not evaluable, 3 had been previously treated and 1 had a wrong diagnosis.
• Exposure: The treatment studied was oral etoposide (Vepesid), 100 mg daily for 21 days followed by 2 weeks without treatment. Asbestos exposure was recorded as definite, probable or possible in 14 of the 19 evaluable patients and as unlikely or unknown in 5. No fiber types were reported.
• Main results:
  • Among the 19 evaluable patients there were no complete responses and one partial response, which lasted 16 months.
  • Disease was stabilised in 15 patients (duration 2 to 10 months), and 3 patients developed progressive disease.
  • Median survival for the group was 17 months after diagnosis. 13 of the 23 patients were still alive at the time of the report.
  • Doses were reduced in 13 of 122 cycles because of treatment-related myelosuppression (low blood counts). There were no treatment-related deaths, and no cycles were discontinued because of toxicity.
  • Of the 23 patients, 10 received 1 to 3 cycles of etoposide and 13 (57%) received 4 cycles or more.
• The authors' conclusion: The authors concluded that the toxicity of this low-dose oral etoposide regimen was acceptable. However, at this dosage it was active against less than 20% of malignant mesothelioma tumours, and routine use of chemotherapy for malignant mesothelioma must remain controversial. They recommended systematic testing of new drugs.
• Limitations the authors state:
  • The authors noted that CT does not detect very small lesions, so some disease may remain in cases that appear to be complete responses.

Topics

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

Medical terms in this study, explained in our Lexicon: Mesothelioma, Peritoneal Mesothelioma, Asbestos Exposure, Median Overall Survival, Chemotherapy.

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