Pemetrexed for malignant pleural mesothelioma: Is it a standard second-line therapy?

Our plain-English summary of Pemetrexed for malignant pleural mesothelioma: Is it a standard second-line therapy?, by K. Tamura, Y. Fujiwara (Asia-Pacific Journal of Clinical Oncology, 2010).

The study

• Authors: K. Tamura, Y. Fujiwara
• Journal: Asia-Pacific Journal of Clinical Oncology
• Published: 2010;6(4):248-50
• Type of article: Comment, Editorial
• Read it: PubMed · Publisher

In plain English

This article was an editorial, not a research study. It asked whether pemetrexed, a chemotherapy drug, is a standard second-line treatment for malignant pleural mesothelioma. The authors noted that an earlier phase III trial by Jassem and colleagues found that second-line pemetrexed did not improve the overall survival of unselected patients. They then commented on a separate retrospective study by Hasani and colleagues of patients treated with pemetrexed at a single institution. As the editorial describes it, that study reported a median time to progression of 5.5 months after first-line treatment and 1.8 months after second-line treatment. It also reported response rates that were not statistically different: 21% for second-line and 14% for first-line treatment. The authors argued that only 15 patients in that study received pemetrexed-based second-line therapy, too few for sufficient statistical power. They added that no conclusions about a standard chemotherapy can be drawn from a non-randomized retrospective analysis. The authors concluded that no optimal second-line treatment has been shown to have high efficacy in advanced malignant pleural mesothelioma. The editorial does not discuss asbestos.

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: editorial (commentary); no original data
• Who was studied: The authors studied no patients themselves. The editorial discusses a retrospective single-institution analysis by Hasani et al. of patients with malignant mesothelioma treated with pemetrexed.
• Exposure: No asbestos exposure is discussed. The subject is pemetrexed chemotherapy, alone or combined with platinum agents, as second-line treatment for malignant pleural mesothelioma.
• Main results:
  • Reported by Jassem et al. (another study, as described in the editorial): second-line pemetrexed did not improve overall survival of unselected patients.
  • Reported by Hasani et al. (another study, as described in the editorial): median time to progression was 5.5 months after first-line treatment and 1.8 months after second-line treatment.
  • Reported by Hasani et al. (as described in the editorial): response rates did not differ statistically, at 21% for second-line and 14% for first-line treatment.
  • The editorial authors' critique: only 15 patients in the Hasani study received pemetrexed-based second-line therapy, a sample too small for sufficient statistical power.
  • The editorial authors' critique: no conclusion about a standard chemotherapy can be drawn from a non-randomized retrospective analysis.
• The authors' conclusion: The authors concluded that no optimal second-line treatment has been shown to have high efficacy in patients with advanced malignant pleural mesothelioma.

Topics

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

Medical terms in this study, explained in our Lexicon: Pemetrexed (Alimta), Pleural Mesothelioma, Second-Line Therapy.

Related studies

• Successful salvage chemotherapy with gemcitabine and vinorelbine in a malignant pleural mesothelioma patient previously treated with pemetrexed — T. Agatsuma, T. Koizumi, et al. (2010)
• Second-line treatment for malignant pleural mesothelioma — G.L. Ceresoli, P.A. Zucali, 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)
• Interaction and cross-resistance of cisplatin and pemetrexed in malignant pleural mesothelioma cell lines — M. Kitazono-Saitoh, Y. Takiguchi, et al. (2012)
• Pemetrexed re-challenge in pleural malignant mesothelioma: an option for a subset of patients initially treated with pemetrexed-platinum doublets in the first-line setting? — G. Zalcman, E. Bergot, et al. (2011)
• A phase II trial of single oral FGF inhibitor, AZD4547, as second or third line therapy in malignant pleural mesothelioma — W.S. Lam, J. Creaney, et al. (2020)

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