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Unresectable Pleural and Peritoneal Mesothelioma Research

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Unresectable Pleural and Peritoneal Mesothelioma Research Powered By Docstoc
					Another interesting study is called, 鈥 淕 efitinib in Patients with Malignant
Mesothelioma: A Phase II Study by the Cancer and Leukemia Group B 鈥?- Clinical
Cancer Research March 2005 11; 2300 by Ramaswamy Govindan, Robert A. Kratzke,
James E. Herndon II, Gloria A. Niehans, Robin Vollmer, Dorothy Watson, Mark R.
Green, Hedy L. Kindler and on behalf of the Cancer and Leukemia Group B. Here is
an excerpt: 鈥淎 bstract - Purpose: The Cancer and Leukemia Group B conducted a
phase II study of gefitinib, an inhibitor of the epidermal growth factor receptor (EGFR)
tyrosine kinase, in patients with previously untreated malignant mesothelioma.
Experimental Design: Eligible patients had unresectable pleural or peritoneal
mesothelioma, measurable disease, no prior therapy, and performance status 0-1 by
Cancer and Leukemia Group B criteria. Gefitinib (500 mg p.o.) was administered
once a day for 21 days. Patients underwent restaging after every two cycles. Therapy
was continued until disease progression or unacceptable toxicity. Results: The most
common grade 3 toxicities were diarrhea (16%) and nausea (12%). Of 43 patients
enrolled, 1 patient (2%) had a complete response, 1 patient (2%) had a partial
response, 21 (49%) had stable disease lasting two to eight cycles, 15 (35%) had
progressive disease, and 5 (12%) had early deaths. One-year survival was 32% [95%
confidence interval (CI), 21-50%]. Median survival and failure-free survival were
6.8% (95% CI, 3.5-10.3) and 2.6 months (95% CI, 1.5-4.0), respectively. The 3-month
failure-free survival was 40% (95% CI, 25-56%). EGFR expression score by
immunohistochemistry done in 28 patients was categorized as low (EGFR 1+ or 2+)
or high (EGFR 3+) expression: 97% had EGFR overexpression (2+ or 3+). The
median and 3-month failure-free survival were 3.6 months and 40% for those patients
with low EGFR expression compared with 8.1 and 40% for those with high EGFR
expression.鈥?
  There were three postoperative complications (16%) requiring reoperation and one
postoperative death (5%). Intrapleural chemotherapy was well tolerated with no
complications. Systemic chemotherapy was poorly tolerated, and there was one
chemotherapy-related death. Sixteen patients (84%) experienced good to excellent
palliation. Three patients are currently alive with no evidence of recurrent disease at
10, 35, and 43 months. The median overall survival was 13 months and the median
disease-free survival, 11 months. Overall and disease-free 3 year survivals were 17%
and 22%, respectively. Patients with epithelial malignant pleural mesothelioma had
significantly better overall survival (p = 0.037) and disease-free survival (p = 0.02)
than patients with sarcomatous or biphasic malignant pleural mesothelioma.
  Another study is called, 鈥淐 isplatin administered by the intracavitary route as
treatment for malignant mesothelioma 鈥?by Maurie Markman MD, Stephen Cleary
PA-C, Craig Pfeifle MD, Stephen B. Howell MD, Cancer Volume 58, Issue 1, pages
18 鈥?1, 1 July 1986. Here is an excerpt: 鈥淎 bstract - Twenty-one patients with
malignant mesothelioma were treated with an experimental Intracavitary
chemotherapy regimen of weekly intraperitoneal or intrapleural cisplatin (90 鈥?00
mg/m2) with simultaneous intravenous sodium thiosulfate delivered to protect against
cisplatin-induced nephrotoxicity. One of eight patients (12.5%) receiving intrapleural
therapy and nine of 13 patients receiving intraperitoneal therapy demonstrated
objective evidence of a clinical response, including three surgically defined major
tumor regressions (23%). Patients receiving intrapleural treatment had more advanced
disease prior to therapy than those receiving intraperitoneal therapy. It was concluded
that intraperitoneal cisplatin is an active treatment program for intra-abdominally
localized mesothelioma. Additional investigation of intrapleural cisplatin should be
undertaken in a patient population with less advanced disease or following surgical
debulking.鈥?Cancer 58:18 鈥?1, 1986.
 We all owe a debt of gratitude to these fine researchers. If you found any of these
excerpts interesting, please read the studies in their entirety.
 Monty Wrobleski is the author of this article. For more information please click on
the following links
 Depuy Hip Recall Lawyer
 Malignant Mesothelioma