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Keisuke Imasaka
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EP1.06 - Mesothelioma (ID 196)
- Event: WCLC 2019
- Type: E-Poster Viewing in the Exhibit Hall
- Track: Mesothelioma
- Presentations: 1
- Now Available
- Moderators:
- Coordinates: 9/08/2019, 08:00 - 18:00, Exhibit Hall
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EP1.06-06 - Retrospective Analysis of Clinical Features and Nonstandard Treatment of Malignant Pleural Mesothelioma in a General Hospital (Now Available) (ID 1072)
08:00 - 18:00 | Presenting Author(s): Keisuke Imasaka
- Abstract
Background
Malignant pleural mesothelioma (MPM) is a relatively rare disease and there are not many cases at a single institution. However, our hospital is closed to the industrial area, so there were relatively many MPM patients who visited our hospital. On the other hand, MPM is disease with poor prognosis, and its standard treatment is also limited. Only two regimens; cisplatin + pemetrexed and nivolumab are approved as standard treatment in Japan. But in clinical practice, other drugs are also used for various reasons. Therefore, it is necessary to clarify the actual condition including nonstandard treatment.
Method
We extracted patients of MPM who visited our hospital during the twelve-year period from April 2007-March 2019. And we carried out a retrospective analysis of the both data of patients who received standard therapy only and nonstandard therapy based on the medical records. And more summarized the clinical course, outcome and various factors.
Result
There were a total of 41 MPM patients, of which 80.5% were male and 19.5% were female, and median age was 72 years old. Sixty-one percent of patients had a history of asbestos exposure. The most common clinical symptom at the first visit was dyspnea (48.8%). In 92.7% patients, pleural effusion was present. Their performance status (PS) at the time of diagnosis was as follows: “0” in 4 cases (9.8%), “1” in 23 cases (56.1%), “2” in 7 case (17.1%), “3” in 7 case (17.1%), and “4-5” in 0 case (0%). By histology of MPM, 17 cases (41.5%) were epithelioid type, 10 cases (24.4%) were biphasic type, 3 cases (7.3%) were sarcomatoid type, and there were 11 other cases (26.8%) (including unknown); classified by the disease stage (IMIG Ver.8), 43.9% patients had “1A”, 7.3% patients had “1B”, 14.6% patients had “2”, 9.8% patients had “3A”, 12.2% patients had “3B”, and 12.2% patients had “4”. Radical surgery could be performed in only 3 cases (7.3%). Chemotherapy was administered in 25 cases (61%), and 16 cases (39%) also received chemotherapy with unapproved drugs and regimens, e.g., pemetrexed only, carboplatin, gemcitabine, vinorelbine, and bevacizumab, etc. The median overall survival (OS) of all patients was 13.8 months. The median OS for patients who received only standard treatment or only palliative treatment was 7.6 months, while the median OS for patients who received unapproved treatment was 16.9 months. The group of patients who received unapproved treatment included 3 cases with PS 2 or more, and also included 47 months of long-term survival cases.
Conclusion
Although it is data of one general hospital, 41 MPM patients could be extracted and analyzed. Nevertheless, it is difficult to show statistically significant differences due to an insufficient number of cases, and factors such as stage and PS are related. However, it can be said that survival tends to be longer in patients who also received unapproved treatment. We will analyze more cases, including patients under observation, and will report these detailed data at the venue.
