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J.C. Pardo Ruiz
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P3.03 - Poster Session with Presenters Present (ID 473)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Mesothelioma/Thymic Malignancies/Esophageal Cancer/Other Thoracic Malignancies
- Presentations: 3
- Moderators:
- Coordinates: 12/07/2016, 14:30 - 15:45, Hall B (Poster Area)
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P3.03-054 - Review and Descriptive Analysis of 140 Patients Diagnosed with Malignant Mesothelioma at Consorci Sanitari Parc Tauli (ID 5855)
14:30 - 14:30 | Author(s): J.C. Pardo Ruiz
- Abstract
Background:
Mesothelioma is a deadly neoplasia related to asbestos, a mineral extensively used in Spain in the 1970-80s until its ban in 2001. The incidence of mesothelioma in the region of Vallès is 1.73 cases / 100,000 inhabitants / year, five times higher than the national average, due to the industrial activity of the area. This rise is likely to increase in the forthcoming years .
Methods:
We describe the epidemiological, diagnostic, pathological and therapeutic characteristics and the overall survival of 140 patients with mesothelioma diagnosed between April 1995 and December 2015 at a single centre.
Results:
The median age was 70 years (44-89), 72.9% were males and 60% had been exposed to asbestos. A total of 55.7% were ECOG 0-1. The origin was pleural in 85% and peritoneal in 12.9%. Histology was: epithelioid in 45%, biphasic in 13.6%, sarcomatoid in 12.9% and unknown in 28.5%. All patients were clinically staged, 31.8% were EIII and 31.8% EIV. Pleurodesis was performed in 43.6%. Fifty percent of patients received palliative chemotherapy (66.2% a combination of platinum plus pemetrexed, 12.7% platinum plus gemcitabine). They received a median of 5 cycles (1-9). The response rate was 43.7%, with 26.8% stabilizations. Reasons for treatment discontinuation were: progression in 36.6% and toxicity in 12.7%. At the time of progression ECOG was 0-1 in 57.7%. Second-line treatment was administered in 46.5%. The median overall survival was 7.4 months (95% CI 4.98-9.91), with significant differences depending on the number of lines of treatment received: 0 vs. 1 vs. ≥2 (3, 8.5, 21.2 months p <0.001). Univariate analysis identified histology (p = 0.033), localization (p <0.001), ECOG (p <0.001), leukocytosis (p = 0.046) and LDH (p <0.001), as potential prognostic factors.
Conclusion:
The results are consistent with the published literature. We found significant differences in survival according to histology, location, ECOG and other prognostic factors previously explored.
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P3.03-055 - Results of Second-Line Chemotherapy in Pleural Mesothelioma: A Single-Centre, Retrospective Study (ID 5860)
14:30 - 14:30 | Author(s): J.C. Pardo Ruiz
- Abstract
Background:
Currently there is no standard treatment for patients with malignant mesothelioma progressing to first-line chemotherapy. Data is available on combined chemotherapy with platinum plus pemetrexed / ralitrexed / gemcitabine depending on previous treatment and on monotherapy treatment.
Methods:
We included 33 patients from a single centre treated with second-line chemotherapy between May 2002 and March 2016 and described their epidemiological, pathological, therapeutic and survival characteristics.
Results:
The median age was 68.2 years (44-84), 69.7% male and 69.7% had been exposed to asbestos. The origin was: 93.9% pleural, pericardial 6.1%. Histology was: 60.6% epithelioid, biphasic 9.1%, 6.1% sarcomatoid and 24.2% unknown. The distribution of clinical stages was: I and II (30.3%), III and IV (48.5%). Palliative pleurodesis was performed in 69.7%. A total of 63.6% had ECOG (0-1) and ECOG (2) 6.1%. The response rate in the first line was 57.6% and 30% of stabilizations. The treatments administered were: platinum + gemcitabine (69.7%), platinum + pemetrexed (12.1%), vinorelbine (9.1%), oxaliplatin + ralitrexed (6.1%), gemcitabine + irinotecan 1p (3%). Retreatment with pemetrexed was administered in 12.1%. Patients received a median of 4 cycles (1-19) of treatment. The response rate was 30.3%, with 21.2% of stabilizations. The treatment was stopped for progression in 48.5% and secondary to toxicity in 27.3%. At the moment of progression ECOG was (0-1) 66.7% and (2-3) 15.2%. Third-line treatment was administered to 39.4%. Progression-free survival was 4.3 months (95% CI 2.303-6.288) with no significant differences according to treatment received (p = 0.064) or PS (p = 0.345). The median overall survival was 9.7 months (95% CI 6.670-12.740). The median time from the last administration of chemotherapy to death was 6.8 months (95% CI 2240-6288).
Conclusion:
In our experience, second-line chemotherapy in malignant mesothelioma is feasible, with a clinical benefit and a response rate that allows third-line treatment to be administered to a non-negligible percentage of patients.
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P3.03-056 - Retrospective Study Comparing Two Frontline Chemotherapy Schemes in Unresectable Malignant Mesothelioma (ID 5724)
14:30 - 14:30 | Author(s): J.C. Pardo Ruiz
- Abstract
Background:
Standard treatment for mesothelioma is platinum-based combination chemotherapy. Selected patients can benefit from surgical procedures and / or radiotherapy. We retrospectively reviewed the results of different platinum doublets administered in clinical practice in our centre.
Methods:
This is a single-centre study of 64 patients with mesothelioma treated with first-line palliative chemotherapy between September 1999 and December 2015. Patients were divided into 2 groups according to the treatment received: (A) 55 patients who received platinum + pemetrexed and (B) 9 patients treated with platinum + gemcitabine. The characteristics of the groups are compared and the results obtained presented.
Results:
Group A characteristics: 75.4% male, mean age 66.7 years. Origin: 91.2% pleural and peritoneal 5.3%. Histology: epithelioid 61.1%, 5.6% biphasic and 33% unknown. Clinical staging III and IV (50.9%) I and II (24.6%). They had PS0 = 31.6%, PS1= 57.9%, PS2 = 5.3%. Group 'B': 77.8% male, mean age 69.9 years. Origin: pleural 77.8% and 22.2% peritoneal. Epithelioid histology 44.4%, 22.2% sarcomatoid and 22.2% unknown. They had PS0 =11.1%, PS1 = 55.6%, PS2= 22.2%, PS3 = 11.1%. There were no significant differences between groups in either prognostic factors or in the indication of palliative pleurodesis. Progression-free survival (A) was 6.7 vs. (B) 2.53 months (p = 0.013). Overall survival (A) was 19.1 months vs. (B) 7.7 months (p = 0.046). The response rate was (A) 50% and (B) 11% (p = 0.19). They received second line: (A) 52.6% vs. (B) 1p (11.1%). G3-4 toxicities: (A) neutropaenia and asthenia (14.1%), anemia (7%), diarrhoea (3.5%), thrombocytopenia, nausea / vomiting, neuropathy, vascular, hearing and dysgeusia (1.8%). In (B) 2p anaemia (22.2%), diarrhoea 1p (11.1%). Median number of cycles (A) 6 vs. (B) 3 (p = 0.084). No significant differences in the number of delays and dose reductions between treatments were observed.
Conclusion:
A significant increase in PFS and OS was achieved with the combination of cisplatin and pemetrexed in our series. The toxicity profile is the expected one with a clinical benefit with cisplatin compared to gemcitabine.
