Recombinant human endostatin (endostar) decreased recurrent ascites, pleural fluid and ascitic VEGF in a case of advanced mesothelioma

Our plain-English summary of Recombinant human endostatin (endostar) decreased recurrent ascites, pleural fluid and ascitic VEGF in a case of advanced mesothelioma, by X. Chen, Y. Liu, Y. Yin, et al (Journal of Chemotherapy, 2012).

The study

• Authors: X. Chen, Y. Liu, Y. Yin, S. Jin, G. Ping, O.D. Røe, K. Yan, Y. Shu, R. Guo
• Journal: Journal of Chemotherapy
• Published: 2012;24(4):231-6
• Type of article: Case report
• Cited by: 5 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

We report a case of 43-year-old male with advanced malignant mesothelioma (MM) with a large amount of fluid in the pleural and peritoneal cavity. The addition of endostar to the gemcitabine-cisplatin regimen gave a prompt and significant improvement of clinical symptoms and disappearance of ascites. The patient is still progression free after 27 months. Endostar, in combination with chemotherapy should be explored in the treatment of MM, especially its effect on pleural and ascitic fluid.

In plain English

This article was a case report about one man, so it described what happened to a single patient. He was 43 years old and Chinese, and was admitted to a hospital in Nanjing, China, in June 2009 with cough and breathlessness. Scans showed a large amount of fluid in his pleural (chest) and peritoneal (abdominal) cavities. A biopsy of the omentum confirmed malignant mesothelioma. The doctors could not tell whether it began in the pleura or the peritoneum. The article did not describe any asbestos exposure for him. His condition did not improve on pemetrexed and cisplatin. Gemcitabine and cisplatin gave stable disease. The doctors then added endostar, a modified recombinant human endostatin. After that he needed no more fluid drainage. The level of VEGF, a growth factor, in his abdominal fluid fell from 5219 to 587 pg/ml by the end of the sixth cycle. A CT scan in December 2011 showed no fluid. He remained without disease progression for more than 27 months. The authors concluded that further clinical studies are needed to establish endostar's role in mesothelioma.

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 43-year-old Chinese man admitted to the First Affiliated Hospital of Nanjing Medical University, China, on 22 June 2009. He had advanced malignant mesothelioma with fluid in both the pleural and peritoneal cavities. The primary site (pleura or peritoneum) could not be determined.
• Exposure: The article studied a drug treatment, not an asbestos exposure, and reported no asbestos history for this patient. Endostar was added from the third cycle of gemcitabine-cisplatin. It was given into the pleural cavity (30 mg per side, day 1), into the abdominal cavity (60 mg, day 5) and intravenously (15 mg, days 0 to 13).
• Main results:
  • After two cycles of pemetrexed and cisplatin, the patient's condition had not improved and a CT scan showed more abdominal fluid.
  • After endostar was added, the patient needed no further fluid aspiration.
  • VEGF in the patient's ascites (abdominal fluid) was 5347 pg/ml at diagnosis.
  • After two cycles of gemcitabine-cisplatin, the patient's ascitic VEGF was 5219 pg/ml. It fell to 1066 pg/ml at the end of the fourth cycle and to 587 pg/ml at the end of the sixth cycle.
  • At the last CT scan, in December 2011, no fluid was detected in the patient's pleural or abdominal cavity, and the authors reported that the peritoneal lesions had decreased.
  • The patient survived without disease progression for more than 27 months, and more than 31 months from the diagnosis of advanced disease.
  • The most serious side effects were Grade 3 neutropenia and fatigue, which occurred during the first 2 cycles of pemetrexed plus cisplatin.
• The authors' conclusion: The authors concluded that the patient's progression-free survival of more than 27 months highlights the need for further clinical studies to establish endostar's role in treating mesothelioma, and that maintenance therapy in malignant mesothelioma deserves more research.

Topics

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

Medical terms in this study, explained in our Lexicon: Ascites, Mesothelioma, Malignant Mesothelioma, Peritoneal Cavity, Gemcitabine, Cisplatin, Chemotherapy.

Related studies

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• The predictive role of serum VEGF in an advanced malignant mesothelioma patient cohort treated with thalidomide alone or combined with cisplatin/gemcitabine — S.C. Kao, R. Harvie, et al. (2012)
• "Signet-ring" cells--a caveat in the diagnosis of a diffuse peritoneal mesothelioma occurring in a lady presenting with recurrent ascites: an unusual case report — B. Rekhi, S. Pathuthara, et al. (2010)
• Metastatic peritoneal mesothelioma in the setting of recurrent ascites: a case report — V. Samedi, S. White, et al. (2010)
• Vascular endothelial growth factor in pleural fluid for differential diagnosis of benign and malignant origin and its clinical applications — A. Fiorelli, G. Vicidomini, et al. (2011)
• Efficacy of Cell-Free and Concentrated Ascites Reinfusion Therapy for Palliative Care in a Patient with Malignant Pleural Mesothelioma: A Case Report — K. Hisakane, H. Ohmatsu, et al. (2017)

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