Author of

• 12736

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  P3.14 - Poster Session 3 - Mesothelioma (ID 197)

  • Event: WCLC 2013
  • Type: Poster Session
  • Track: Mesothelioma
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/30/2013, 09:30 - 16:30, Exhibit Hall, Ground Level

  • 12738

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    P3.14-002 - Second Line- Chemotherapy Treatment Options, In Malignant Mesothelioma Tumors, Resistant To Pemetrexed. (ID 343)

    09:30 - 09:30  |  Author(s): A. Kopitopoulou
    • Abstract

    Background
    The number of patients with Malignant Mesothelioma is expected to increase over the next ten years from the number of 3.300 new cases that are reported annually nowadays. Most of the patients appear with advanced, surgically unresectable disease at the time of diagnosis and relapse is usual after the standard 1st line treatment with a platinum-pemetrexed doublet, due to intrinsic and acquired resistance to pemetrexed. This review focuses on the treatment options in Malignant Mesothelioma resistant to pemetrexed and is based on trials for possible 2nd line regimens tested the last ten years and ongoing trials of novel agents and studies exploring the basis of pemetrexed resistance.

    Methods
    We searched via PubMed/Medline, Clinicaltrials.gov and American Society of Clinical Oncology databases for articles and ongoing trials published until 1/2013 using the term: “mesothelioma”, in association with “2nd line chemotherapy”, “pemetrexed resistance”, “relapsed”, “pemetrexed-pretreated” and “biomarker”. Primary sources have been quoted.

    Results
    Data from forty eight conducted and ongoing trials, mainly phase II, single-armed, but also retrospective and phase III, are shown and discussed. Thirty different agents were tested in these trials as possible 2nd line drugs for Malignant Mesothelioma. Currently, no guidelines for 2nd line chemotherapy in Malignant Mesothelioma tumors resistant to pemetrexed are available.

    Conclusion
    In the absence of a “gold standard” as 2nd line treatment for Malignant Mesothelioma, results of ongoing trials are eagerly awaited and the research for novel agents remains critical. Furthermore, additional research should be done towards the understanding of the mechanisms that lead to pemetrexed resistance, the possible personalization of 1st and 2nd line treatment and the use of biomarkers that can be used as factors predicting the resistance itself. Finally, more patients should be convinced to enroll in clinical trials and more randomized trials have to be conducted.