Gemcitabine and vinorelbine as second-line or beyond treatment in patients with malignant pleural mesothelioma pretreated with platinum plus pemetrexed chemotherapy

Gouji Toyokawa, Mitsuhiro Takenoyama, Fumihiko Hirai, Ryo Toyozawa, Eiko Inamasu, Miyako Kojo, Yosuke Morodomi, Yoshimasa Shiraishi, Tomoyoshi Takenaka, Masafumi Yamaguchi, Mototsugu Shimokawa, Takashi Seto, Yukito Ichinose

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Abstract

Background: Malignant pleural mesothelioma (MPM) is an aggressive neoplasm that responds poorly to chemotherapy. Although treatment with pemetrexed in combination with cisplatin serves as first-line chemotherapy for MPM, the optimal second-line and beyond therapy has not yet been fully examined. Methods: Between March 2008 and October 2011, 17 consecutive Japanese patients pretreated with at least one regimen of platinum plus pemetrexed chemotherapy received gemcitabine and vinorelbine. Responses, survival time, and toxicity were retrospectively evaluated. Results: Response [partial response (PR) + complete response (CR)] and disease control [stable disease (SD) + PR + CR] rates were 18 and 82 %, respectively. The median progression-free survival (PFS) after combination chemotherapy was 6.0 months, whereas the median overall survival (OS) was 11.2 months. Grade 3 or 4 neutropenia and anemia were observed in 41 and 29 % of patients, respectively, and one patient experienced febrile neutropenia. Grade 3 or 4 nonhematologic toxicities included constipation (6 %) and phlebitis (6 %). Conclusion: Combination chemotherapy using gemcitabine with vinorelbine was shown to have moderate activity in Japanese MPM patients pretreated with platinum plus pemetrexed chemotherapy. A further multicenter phase II trial is warranted to confirm the efficacy and safety of this combination treatment.

Original languageEnglish
Pages (from-to)601-606
Number of pages6
JournalInternational Journal of Clinical Oncology
Volume19
Issue number4
DOIs
Publication statusPublished - Jan 1 2014

All Science Journal Classification (ASJC) codes

  • Surgery
  • Hematology
  • Oncology

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    Toyokawa, G., Takenoyama, M., Hirai, F., Toyozawa, R., Inamasu, E., Kojo, M., Morodomi, Y., Shiraishi, Y., Takenaka, T., Yamaguchi, M., Shimokawa, M., Seto, T., & Ichinose, Y. (2014). Gemcitabine and vinorelbine as second-line or beyond treatment in patients with malignant pleural mesothelioma pretreated with platinum plus pemetrexed chemotherapy. International Journal of Clinical Oncology, 19(4), 601-606. https://doi.org/10.1007/s10147-013-0619-5