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R. Dienstmann

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    Poster Display session (Friday) (ID 65)

    • Event: ELCC 2018
    • Type: Poster Display session
    • Track:
    • Presentations: 1
    • Moderators:
    • Coordinates: 4/13/2018, 12:30 - 13:00, Hall 1
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      219P - Outcomes of malignant pleural mesothelioma (MPM) patients (p) treated after first line chemotherapy (CT) (ID 510)

      12:30 - 13:00  |  Author(s): R. Dienstmann

      • Abstract
      • Slides

      The increasing incidence and poor outcome associated with MPM requires identification of novel treatment options. Initial reports have demonstrated beneficial effects of pemetrexed, gemcitabine and vinorelbine in previously treated MPM, however there is no clear agreement on the role of different agents after first line. The aim of this study is to evaluate the outcomes of p with MPM treated in second and third lines at our institution.

      91 MPM p treated with CT or experimental agents in clinical trials beyond first line between September 2002 and October 2017 were retrospectively reviewed (49 p received a third line regimen). Survival was calculated using the Kaplan–Meier method and log-rank test was used for statistical comparison. The associations of type of regimen with outcomes were assessed with Cox proportional-hazard models.

      Patient's characteristics: median age 65 years (29–84 years), males: 73%, performance status 1: 66%, asbestos exposure: 81%, stage III at diagnosis: 48%, epithelial subtype: 77%. All p were treated with chemotherapy in first line, 77% received cisplatin plus pemetrexed, 19% carboplatin plus pemetrexed and 4% others. Median PFS in first line was 5.1 months (m; CI95% 4.6–5.2). Median overall survival after first line was 11.6 m (9.8–15.9). Regimen offered as second- or third-line: platinum doublet in 24%, vinorelbine in 32%, gemcitabine in 10%, immunotherapy in 22%, and targeted agents in 12%. Median PFS in second or third line with platinum doublet was 4.9 m (4.3–5.9), vinorelbine 2.7 m (2.1–3.8), gemcitabine 3 m (1.4 – NA), immunotherapy 3 m (2.2–4.5) and targeted agents 3 m (0.8 – NA) (p > 0.05). In the third line setting, median survival after initiation of vinorelbine was 8.5 m (5.5 – NA) versus 3 m (3 – NA) for gemcitabine-treated p (p = 0.001).

      In our single institution series of previously treated MPM p, second or third line treatment produces modest benefit, with no clear differences in outcome for CT or clinical trial alternatives. Further research is necessary to treat p who failed to first line CT, including choice of therapy sequence in the second and third lines.

      Clinical trial identification:

      Legal entity responsible for the study:

      Has not received any funding

      All authors have declared no conflicts of interest.

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