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Simon GR, Janne PA, Langer C, Clarie V, Dowlati A, Gadgeel SM, Kelly K, Ye Z, Obasaju CK, Hood KE, Kindler HL. A finalized phase II report of pemetrexed (P) plus gemcitabine (G) as front-line chemotherapy for patients with peritoneal mesothelioma (PM). J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.2050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
2050 Background: P in combination with cisplatin is approved for the treatment of malignant pleural mesothelioma. In an expanded access program, P ± cisplatin was shown to have activity in PM. P plus G are synergistic in preclinical models, but the activity of this combination in PM is unknown. The primary objective of this study was to determine time to disease progression in pts with PM receiving P plus G. Methods: Twenty pts were accrued. Treatment consisted of G 1250 mg/m2/30 minutes on D 1 and 8, and P 500mg/m2 /10 minutes on D 8, immediately before G. Treatment was repeated every 21 days for a total of 6 cycles or until progressive disease. All received folic acid, vitamin B12 and steroid prophylaxis. Results: Median age was 67.5 years (range: 46–79). Histology was epithelial:other = 14:6, M:F = 15:5, and ECOG PS 0:1:2 = 9:6:4. A total of 93 cycles (median 6) were administered. Patient-specific Grade 3/4 hematologic toxicity included neutropenia (60.0%), febrile neutopenia (10%; including one toxic death), anemia (5%), and thrombocytopenia (0%). Grade 3/4 nonhematologic events were fatigue (20.0%), constipation (10.0%), diarrhea (5.0%), peripheral neuropathy (5.0%), and dyspnea (5.0%). Median relative dose intensity was 94.5% for P and 82.9% for G respectively. Investigator-reported response rate was 15% (95% CI: 3.2–37.9%) with 1CR, 2PR, 7SD, 7PD, and 3 Unknown. Median time to progressive disease (MTTPD) and median survival (MS) were and 16.5 months (95% C: 6.6-TBD) and 19.1 months (95% CI: 6.6-TBD) respectively. Conclusions: P plus G is well tolerated in patients with PM. The clinical benefit rate (PR + SD) of 50%, MTTP and MS suggest that this non-platinum doublet can be a reasonable alternative to a platinum doublet in this disease. [Table: see text]
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Affiliation(s)
- G. R. Simon
- H. Lee Moffitt Cancer Center, Tampa, FL; Dana-Farber Cancer Institute, Boston, MA; Fox Chase Cancer Center, Philadelphia, PA; University of New Mexico Cancer Research & Cancer, Albuquerque, NM; Case Western Reserve University, Cleveland, OH; Wayne State University, Detroit, MI; University of Colorado Health Sciences Center, Aurora, CO; Eli Lilly and Company, Indianapolis, IN; University of Chicago, Chicago, IL
| | - P. A. Janne
- H. Lee Moffitt Cancer Center, Tampa, FL; Dana-Farber Cancer Institute, Boston, MA; Fox Chase Cancer Center, Philadelphia, PA; University of New Mexico Cancer Research & Cancer, Albuquerque, NM; Case Western Reserve University, Cleveland, OH; Wayne State University, Detroit, MI; University of Colorado Health Sciences Center, Aurora, CO; Eli Lilly and Company, Indianapolis, IN; University of Chicago, Chicago, IL
| | - C. Langer
- H. Lee Moffitt Cancer Center, Tampa, FL; Dana-Farber Cancer Institute, Boston, MA; Fox Chase Cancer Center, Philadelphia, PA; University of New Mexico Cancer Research & Cancer, Albuquerque, NM; Case Western Reserve University, Cleveland, OH; Wayne State University, Detroit, MI; University of Colorado Health Sciences Center, Aurora, CO; Eli Lilly and Company, Indianapolis, IN; University of Chicago, Chicago, IL
| | - V. Clarie
- H. Lee Moffitt Cancer Center, Tampa, FL; Dana-Farber Cancer Institute, Boston, MA; Fox Chase Cancer Center, Philadelphia, PA; University of New Mexico Cancer Research & Cancer, Albuquerque, NM; Case Western Reserve University, Cleveland, OH; Wayne State University, Detroit, MI; University of Colorado Health Sciences Center, Aurora, CO; Eli Lilly and Company, Indianapolis, IN; University of Chicago, Chicago, IL
| | - A. Dowlati
- H. Lee Moffitt Cancer Center, Tampa, FL; Dana-Farber Cancer Institute, Boston, MA; Fox Chase Cancer Center, Philadelphia, PA; University of New Mexico Cancer Research & Cancer, Albuquerque, NM; Case Western Reserve University, Cleveland, OH; Wayne State University, Detroit, MI; University of Colorado Health Sciences Center, Aurora, CO; Eli Lilly and Company, Indianapolis, IN; University of Chicago, Chicago, IL
| | - S. M. Gadgeel
- H. Lee Moffitt Cancer Center, Tampa, FL; Dana-Farber Cancer Institute, Boston, MA; Fox Chase Cancer Center, Philadelphia, PA; University of New Mexico Cancer Research & Cancer, Albuquerque, NM; Case Western Reserve University, Cleveland, OH; Wayne State University, Detroit, MI; University of Colorado Health Sciences Center, Aurora, CO; Eli Lilly and Company, Indianapolis, IN; University of Chicago, Chicago, IL
| | - K. Kelly
- H. Lee Moffitt Cancer Center, Tampa, FL; Dana-Farber Cancer Institute, Boston, MA; Fox Chase Cancer Center, Philadelphia, PA; University of New Mexico Cancer Research & Cancer, Albuquerque, NM; Case Western Reserve University, Cleveland, OH; Wayne State University, Detroit, MI; University of Colorado Health Sciences Center, Aurora, CO; Eli Lilly and Company, Indianapolis, IN; University of Chicago, Chicago, IL
| | - Z. Ye
- H. Lee Moffitt Cancer Center, Tampa, FL; Dana-Farber Cancer Institute, Boston, MA; Fox Chase Cancer Center, Philadelphia, PA; University of New Mexico Cancer Research & Cancer, Albuquerque, NM; Case Western Reserve University, Cleveland, OH; Wayne State University, Detroit, MI; University of Colorado Health Sciences Center, Aurora, CO; Eli Lilly and Company, Indianapolis, IN; University of Chicago, Chicago, IL
| | - C. K. Obasaju
- H. Lee Moffitt Cancer Center, Tampa, FL; Dana-Farber Cancer Institute, Boston, MA; Fox Chase Cancer Center, Philadelphia, PA; University of New Mexico Cancer Research & Cancer, Albuquerque, NM; Case Western Reserve University, Cleveland, OH; Wayne State University, Detroit, MI; University of Colorado Health Sciences Center, Aurora, CO; Eli Lilly and Company, Indianapolis, IN; University of Chicago, Chicago, IL
| | - K. E. Hood
- H. Lee Moffitt Cancer Center, Tampa, FL; Dana-Farber Cancer Institute, Boston, MA; Fox Chase Cancer Center, Philadelphia, PA; University of New Mexico Cancer Research & Cancer, Albuquerque, NM; Case Western Reserve University, Cleveland, OH; Wayne State University, Detroit, MI; University of Colorado Health Sciences Center, Aurora, CO; Eli Lilly and Company, Indianapolis, IN; University of Chicago, Chicago, IL
| | - H. L. Kindler
- H. Lee Moffitt Cancer Center, Tampa, FL; Dana-Farber Cancer Institute, Boston, MA; Fox Chase Cancer Center, Philadelphia, PA; University of New Mexico Cancer Research & Cancer, Albuquerque, NM; Case Western Reserve University, Cleveland, OH; Wayne State University, Detroit, MI; University of Colorado Health Sciences Center, Aurora, CO; Eli Lilly and Company, Indianapolis, IN; University of Chicago, Chicago, IL
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