Clinical Study

British Journal of Cancer (2008) 99, 51–56. doi:10.1038/sj.bjc.6604442 www.bjcancer.com
Published online 10 June 2008

Pemetrexed plus carboplatin in elderly patients with malignant pleural mesothelioma: combined analysis of two phase II trials

The results of this study were presented in part at the 8th Conference of the International Mesothelioma Interest Group (IMIG) in Chicago, IL, USA, 19–22 October 2006, and at the 9th Congress of the Italian Association of Medical Oncology (AIOM) in Palermo, Italy, 12–15 October 2007.

G L Ceresoli1, B Castagneto2, P A Zucali1, A Favaretto3, M Mencoboni4, F Grossi5, D Cortinovis6, G Del Conte7, A Ceribelli8, A Bearz9, S Salamina1, F De Vincenzo1, F Cappuzzo1, M Marangolo10, V Torri11 and A Santoro1

  1. 1Department of Oncology, Istituto Clinico Humanitas IRCCS, Rozzano, Milano, Italy
  2. 2Department of Medical Oncology, Azienda Ospedaliera, Novi Ligure, Italy
  3. 3Department of Medical Oncology, Istituto Oncologico Veneto IRCCS, Padova, Italy
  4. 4Department of Medical Oncology, Ospedale Villa Scassi, Sampierdarena, Italy
  5. 5Department of Medical Oncology, National Institute for Cancer Research, Genova, Italy
  6. 6Department of Medical Oncology, Unit 2, National Cancer Institute, Milano, Italy
  7. 7Department of Medical Oncology, Azienda Ospedaliera, Trieste, Italy
  8. 8Department of Medical Oncology, Unit A, Regina Elena Cancer Institute, Roma, Italy
  9. 9Department of Medical Oncology, Unit A, National Cancer Institute, Aviano, Italy
  10. 10Department of Oncology and Hematology, Istituto Oncologico Romagnolo, Ravenna, Italy
  11. 11Department of Oncology, Istituto Mario Negri, Milano, Italy

Correspondence: Dr GL Ceresoli, E-mail: giovanni_luca.ceresoli@humanitas.it

Revised 15 April 2008; Accepted 24 April 2008; Published online 10 June 2008.

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Abstract

The incidence of malignant pleural mesothelioma (MPM) in elderly patients is increasing. In this study, pooled data from two phase II trials of pemetrexed and carboplatin (PC) as first-line therapy were retrospectively analysed for comparisons between age groups. Patients received pemetrexed 500 mg m-2 and carboplatin AUC 5 mg ml-1 min-1 intravenously every 21 days with standard vitamin supplementation. Elderly patients were defined as those greater than or equal to70 years old. A total of 178 patients with an ECOG performance status of less than or equal to2 were included. Median age was 65 years (range 38–79), with 48 patients greater than or equal to70 years (27%). Grade 3–4 haematological toxicity was slightly worse in greater than or equal to70 vs <70-year-old patients, with neutropenia observed in 25.0 vs 13.8% (P=0.11), anaemia in 20.8 vs 6.9% (P=0.01) and thrombocytopenia in 14.6 vs 8.5% (P=0.26). Non-haematological toxicity was mild and similar in the two groups. No significant difference was observed in terms of overall disease control (60.4 vs 66.9%, P=0.47), time to progression (7.2 vs 7.5 months, P=0.42) and survival (10.7 vs 13.9 months, P=0.12). Apart from slightly worse haematological toxicity, there was no significant difference in outcome or toxicity between age groups. The PC regimen is effective and well tolerated in selected elderly patients with MPM.

Keywords:

malignant pleural mesothelioma, elderly patients, chemotherapy, carboplatin, pemetrexed