Treatment of malignant mesothelioma with epirubicin and ifosfamide: a phase II cooperative study

Our plain-English summary of Treatment of malignant mesothelioma with epirubicin and ifosfamide: a phase II cooperative study, by M.D. Magri, S. Foladore, A. Veronesi, et al (Annals of Oncology, 1992).

The study

• Authors: M.D. Magri, S. Foladore, A. Veronesi, C. Serra, M. Nicotra, M. Tommasi, G. Grandi, S. Monfardini, C. Bianchi
• Journal: Annals of Oncology
• Published: 1992;3(3):237-8
• Cited by: 24 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

From May 1988 to March 1990, 17 consecutive patients with histologically proven malignant mesothelioma were treated with epirubicin 75 mg/sqm i.v. on day 1 and ifosfamide 1.8 gr/sqm/day i.v. from day 1-5. Treatment was repeated every 3 weeks until progression. Fifty-three chemotherapy cycles were administered to the 17 patients treated (median, 3 cycles/patient). No complete responses, 1 partial response, 8 stable diseases and 8 progressions were noted. Toxocity was acceptable and no treatment-related deaths occurred. Actuarial median survival was 6 months. In this study, a combination of full doses of epirubicin and ifosfamide did not prove to be active in malignant mesothelioma.

In plain English

This short report described a phase II trial, an early test of whether a treatment works, run by a cooperative group of north-eastern Italian hospitals. From May 1988 to March 1990, 17 consecutive patients with malignant mesothelioma confirmed by tissue examination received two chemotherapy drugs: epirubicin on day 1 and ifosfamide on days 1 to 5. The course was repeated every 3 weeks until the disease worsened. The patient table shows all 17 were men, and all had mesothelioma starting in the pleura, the lining of the chest. Median age was 58. The article did not report the patients' asbestos exposure. In total, 53 treatment cycles were given (median 3 per patient). No patient's tumour disappeared completely. One patient had a partial response, 8 had stable disease and 8 got worse. Lowered blood counts occurred in 11 patients, and one patient had a temporary episode of coma. The authors judged side effects acceptable, and no deaths were caused by treatment. Median survival was 6 months. The authors concluded the combination was inactive and no better than epirubicin alone, which they had tested earlier.

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 cooperative (multi-centre) chemotherapy trial, single treatment arm; short report
• Who was studied: 17 consecutive patients with histologically proven malignant mesothelioma treated May 1988 to March 1990 at centres in north-eastern Italy; per the patient table, 17 men and 0 women, all pleural (17 pleural, 0 peritoneal), median age 58 (range 41-70), no previous chemotherapy
• Exposure: Not an asbestos exposure study; the article reports no asbestos exposure information. The treatment studied was epirubicin 75 mg/sqm i.v. on day 1 plus ifosfamide 1.8 gr/sqm/day i.v. on days 1-5, repeated every 3 weeks until progression
• Main results:
  • 53 chemotherapy cycles were given to the 17 patients (median 3 cycles per patient)
  • Among the 17 patients: no complete responses, 1 partial response, 8 stable disease, 8 progression
  • Myelosuppression (lowered blood counts) occurred in 11 patients: grade I in 2, grade II in 4, grade III in 3, grade IV in 2
  • One patient had a transient episode of coma
  • The authors judged toxicity acceptable; no treatment-related deaths occurred
  • Actuarial median survival was 6 months
• The authors' conclusion: The authors concluded that full doses of epirubicin plus ifosfamide were inactive in malignant mesothelioma and no better than epirubicin alone, which they had tested in an earlier study. They also concluded that the disease remains very resistant to chemotherapy

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, Chemotherapy, Median Overall Survival.

Related studies

• Epirubicin in malignant mesothelioma: a phase II study of the European Organization for Research and Treatment of Cancer Lung Cancer Cooperative Group — K. Mattson, G. Giaccone, et al. (1992)
• Combined epirubicin and interleukin-2 regimen in the treatment of malignant mesothelioma: a multicenter phase II study of the Italian Group on Rare Tumors — S. Bretti, A. Berruti, et al. (1998)
• Epirubicin and gemcitabine as first-line treatment in malignant pleural mesothelioma — L. Portalone, A. Antilli, et al. (2005)
• A phase II trial of dose-escalated doxorubicin and ifosfamide/mesna in patients with malignant mesothelioma — L.Y. Dirix, J. van Meerbeeck, et al. (1994)
• Ifosfamide in malignant mesothelioma: a phase II study — M.K. Andersen, A. Krarup-Hansen, et al. (1999)
• Gemcitabine with or without ramucirumab as second-line treatment for malignant pleural mesothelioma (RAMES): a randomised, double-blind, placebo-controlled, phase 2 trial — C. Pinto, P.A. Zucali, et al. (2021)

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