Back to Search
Start Over
Prospective study of combination chemotherapy with cyclophosphamide, doxorubicin, and cisplatin for unresectable or metastatic malignant pleural mesothelioma.
- Source :
-
Cancer [Cancer] 1995 Dec 01; Vol. 76 (11), pp. 2230-6. - Publication Year :
- 1995
-
Abstract
- Background: This study was designed to determine the efficacy and side effects of a combination of cyclophosphamide (C), doxorubicin (D), and cisplatin (P) in patients with inoperable, unresectable, or metastatic malignant pleural mesothelioma.<br />Methods: Twenty-three patients with unresectable or metastatic malignant pleural mesothelioma were entered onto the study. The median age was 62 years (range, 42-74 years); there were 20 males and 3 females; the median performance status was 1 (Zubrod's scale). The histologic types included epithelial (14 patients), sarcomatoid (4 patients), unclassified (4 patients), and mixed type (1 patient). Twenty patients were known to have been exposed to asbestos and 3 were not. All patients were treated with the following starting dose of chemotherapy: a cycle comprised of C, 500 mg/m2 intravenously, day 1; D, 50 mg/m2 intravenously, day 1; and P, 80 mg/m2 intravenously, day 1 every 3 weeks. The cisplatin dose was reduced to 50 mg/m2 for the subsequent courses. For the assessment of tumor response, all patients had computed tomography scans of the chest after each three cycles of chemotherapy.<br />Results: Overall, 7 of 23 patients (30%) had partial responses (durations of responses [weeks]: 158+, 91+, 70+, 41+, 40, 39, 25), three had minor responses, and 14 had stable or progressive disease. One partial responder later underwent surgical resection and no viable tumors cells were found in the pathologic specimen. All patients have stopped treatment, and eight are still alive. The most common side effect was granulocytopenia (grade 4, 52%; grade 3, 17%). Other hematologic side effects were modest. Nonhematologic side effects included mild to moderate nausea and vomiting, neutropenic fever (three patients), peripheral neuropathy (one patient), and congestive heart failure (one patient). The overall median duration of survival was 60 weeks.<br />Conclusion: Combination chemotherapy with CDP was well tolerated and had significant activity against unresectable or metastatic malignant pleural mesothelioma. The median duration of responses was 60 weeks; however, the survival rate was far from satisfactory. Continued development of new approaches including the biologic understanding of tumor development and testing new agents is warranted.
- Subjects :
- Adult
Aged
Agranulocytosis chemically induced
Antibiotics, Antineoplastic adverse effects
Antineoplastic Agents adverse effects
Antineoplastic Agents, Alkylating adverse effects
Antineoplastic Combined Chemotherapy Protocols administration & dosage
Antineoplastic Combined Chemotherapy Protocols adverse effects
Cisplatin adverse effects
Cyclophosphamide adverse effects
Disease Progression
Disease-Free Survival
Doxorubicin adverse effects
Drug Administration Schedule
Female
Fever chemically induced
Humans
Male
Mesothelioma secondary
Middle Aged
Nausea chemically induced
Neutropenia chemically induced
Prospective Studies
Remission Induction
Survival Rate
Vomiting chemically induced
Antibiotics, Antineoplastic administration & dosage
Antineoplastic Agents administration & dosage
Antineoplastic Agents, Alkylating administration & dosage
Antineoplastic Combined Chemotherapy Protocols therapeutic use
Cisplatin administration & dosage
Cyclophosphamide administration & dosage
Doxorubicin administration & dosage
Mesothelioma drug therapy
Pleural Neoplasms drug therapy
Subjects
Details
- Language :
- English
- ISSN :
- 0008-543X
- Volume :
- 76
- Issue :
- 11
- Database :
- MEDLINE
- Journal :
- Cancer
- Publication Type :
- Academic Journal
- Accession number :
- 8635025
- Full Text :
- https://doi.org/10.1002/1097-0142(19951201)76:11<2230::aid-cncr2820761108>3.0.co;2-2