Pegylated liposomal doxorubicin in malignant pleural mesothelioma: a possible guardian for long-term survival

Our plain-English summary of Pegylated liposomal doxorubicin in malignant pleural mesothelioma: a possible guardian for long-term survival, by P. Zarogoulidis, M. Mavroudi, K. Porpodis, et al (OncoTargets and Therapy, 2012).

The study

• Authors: P. Zarogoulidis, M. Mavroudi, K. Porpodis, K. Domvri, A. Sakkas, N. Machairiotis, A. Stylianaki, A. Tsiotsios, N. Courcoutsakis, K. Zarogoulidis
• Journal: OncoTargets and Therapy
• Published: 2012;5:231-6
• Type of article: Case report
• Cited by: 4 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Malignant pleural mesothelioma is a rare and aggressive malignancy of the pleura correlated with exposure to asbestos, with a medium survival of 11-12 months after diagnosis. A case of a 67-year-old male who had previously worked in the asbestos industry and is a current smoker is reported. The computed tomography evaluation revealed a right pleural mass with pleural thickening, and the pleural biopsy confirmed a diagnosis of malignant pleural mesothelioma. He was treated with chemotherapy consisting of etoposide, paclitaxel, and pegylated liposomal doxorubicin hydrochloride. After completion of chemotherapy, radiologic evaluation confirmed a reduction of pleural thickening and improvement in his symptoms. A complete presentation of each drug formulation and characteristics are also included in this paper. The patient's follow-up is continuing, and computed tomography reveals stable disease 9 years after initial examination.

In plain English

This case report described one man, a 67-year-old pensioner treated in the authors' hospital department in Thessaloniki, Greece. He had formerly worked in the asbestos industry and was a current smoker (30 cigarettes a day for 47 years). The article did not say which asbestos fiber type he was exposed to. He came to the emergency department with right-sided chest pain and shortness of breath. A CT scan showed a mass and thickening of the right pleura, and a biopsy taken during thoracoscopy was positive for malignant pleural mesothelioma. CT also showed an adrenal gland mass, and the authors wrote that it was never confirmed to be malignant. He received eight cycles of paclitaxel, pegylated liposomal doxorubicin (Caelyx) and etoposide. He then received maintenance cycles of etoposide and cyclophosphamide but declined to complete them. Pleural thickness fell from 90 mm × 20 mm at diagnosis to 40 mm × 15 mm after first-line treatment. After 9 years of follow-up the disease was reported stable without progression. The authors concluded that pegylated liposomal doxorubicin should not be disregarded as an alternative for patients who cannot tolerate other first-line chemotherapy. This report describes one patient's course, not a rate.

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 (single patient), with a discussion of the drugs used
• Who was studied: One 67-year-old male pensioner with malignant pleural mesothelioma, treated in the authors' department (hospital in Thessaloniki, Greece); dates of treatment not given beyond 9 years of follow-up
• Exposure: Former work in the asbestos industry (fiber type, job and duration not specified); also a current smoker, 30 cigarettes per day for 47 years
• Main results:
  • Diagnosis: CT showed a right peripheral pleural mass with pleural thickening; a thoracoscopic pleural biopsy was positive for malignant pleural mesothelioma
  • Treatment: eight cycles of paclitaxel (175 mg/m2), pegylated liposomal doxorubicin hydrochloride (Caelyx 20 mg/m2) and etoposide (200 mg/m2)
  • Maintenance: three cycles of etoposide (100 mg/m2 on days one to five) and three cycles of cyclophosphamide (150 mg/m2 on days one to seven); the patient refused to complete maintenance therapy
  • Chest CT after treatment showed reduced pleural thickening and no pathological lymph nodes
  • Pleural thickness was 90 mm × 20 mm at diagnosis and 40 mm × 15 mm at the end of first-line treatment
  • An additional biopsy 5 years after the initial examination was positive for AE1/AE3, Wilms tumor gene-1, calretinin and D2-40, and negative for polyclonal carcinoembryonic antigen and thyroid transcription factor-1
  • The adrenal gland lesion remained stable; its malignancy was never confirmed. Bone scans and brain CT scans were not pathological
  • At 9 years of follow-up the disease was stable without progression
• The authors' conclusion: The authors concluded that pegylated liposomal doxorubicin should not be disregarded and should be used as an alternative in patients who cannot tolerate other first-line chemotherapy regimens. They also wrote that, despite treatment progress, the data for malignant pleural mesothelioma are not yet promising.
• Limitations the authors state:
  • The authors state that the adrenal gland lesion was never confirmed to be malignant

Topics

Medical terms in this study, explained in our Lexicon: Doxorubicin, Pleural Mesothelioma, Pleura, Pleural Thickening, Pleural Biopsy, Chemotherapy.

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