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Category: Mesothelioma

A Review of Chemotherapy Trials for Malignant Mesothelioma: Conclusion

Despite many investigations, no chemotherapeutic protocol has yet emerged as an effective treatment for malignant pleural mesothelioma. Previous studies have been hindered by small size, inability to accurately measure disease extent, absence of a precise staging system, and lack of knowledge regarding the natural history of the disease. Cohesive, multi-institutional studies have become necessary to […]

A Review of Chemotherapy Trials for Malignant Mesothelioma: Cisplatin-Based Combinations

Among the cisplatin-based regimens, cisplatin given with mitomycin in one arm of CALGB 8435 resulted in a 26% response rate, including two CRs. Tsavaris et al evaluated cisplatin (100 mg/m2) combined with vinblastine (6 mg/m2) in 20 patients, reporting one CR and four PRs (25% response) with a 13-month mean duration of response. One study […]

A Review of Chemotherapy Trials for Malignant Mesothelioma: Combination Chemotherapy

Combination chemotherapy regimens have been evaluated in a number of studies, but have not shown any clear advantage over single-agent chemotherapy (Table 5). Most combination chemotherapy┬ástudies have included doxorubicin, cisplatin, or an alkylating agent, reflecting the popularity of these drugs based on their mild efficacy in single-agent trials. Doxorubicin-Based Combinations Doxorubicin has been combined with […]

A Review of Chemotherapy Trials for Malignant Mesothelioma: Antimetabolites

Antimetabolites The antifolates have shown promise in the treatment of malignant mesothelioma. A favorable response rate of 37%, including one complete response (CR), was shown by Solheim et al in a group of 60 patients who received high-dose methotrexate (3 g total dose at 10- and 21-day intervals). Variable activity has been seen with two […]

A Review of Chemotherapy Trials for Malignant Mesothelioma: Plant Alkaloids

Plant Alkaloids The vinca alkaloids have not shown activity against mesothelioma. Vindesine produced only one response among 17 patients in a series using 3 mg/m2/wk and no responses in a study of 2 mg/m2/wk Single trials of vinblastine and vincristine have been equally disappointing, with no responses observed in either study. Poor results have also […]

A Review of Chemotherapy Trials for Malignant Mesothelioma: Single-Agent Chemotherapy

Numerous single agents have been tested for activity against mesothelioma. In the past, many small studies reported relative success, but these may have represented a bias toward publishing positive results. Such favorable outcomes have usually not been confirmed by larger, follow-up series. Table 4 summarizes the larger singleagent chemotherapy trials that have included 15 patients. […]

A Review of Chemotherapy Trials for Malignant Mesothelioma: Methods

The role of systemic chemotherapy for malignant pleural mesothelioma continues to be an area of active investigation. Numerous agents have been tested over the years, but few have shown any clear benefit, and no regimen has emerged as a standard of care. Because of the rarity of the disease, most trials have been small and […]

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