Difference between revisions of "Malignant pleural mesothelioma"

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'''Use of this site is subject to you reading and agreeing with the terms set forth in the [[HemOnc.org_-_A_Hematology_Oncology_Wiki:General_disclaimer|disclaimer]].'''
 
'''Use of this site is subject to you reading and agreeing with the terms set forth in the [[HemOnc.org_-_A_Hematology_Oncology_Wiki:General_disclaimer|disclaimer]].'''
  
−
Is there a regimen missing from this list? Would you like to share a different dosage/schedule or an additional reference for a regimen? Have you noticed an error? Do you have an idea that will help the site grow to better meet your needs and the needs of many others? You are [[How_to_contribute|invited to contribute to the site]].
+
Is there a regimen missing from this list? Would you like to share a different dosage/schedule or an additional reference for a regimen? Have you noticed an error? Do you have an idea that will help the site grow to better meet your needs and the needs of many others? You are [[How_to_contribute|invited to contribute to the site]].
  
 
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|<div style="background-color: #66FF66; border: 1px solid #808000; padding: 5px; {{border-radius|16px}}" align="right"><font size="4"><b>{{#ask: [[-Has subobject::{{FULLPAGENAME}}]] |?Regimen |limit=10000|format=sum}} regimens on this page</b></font></div>
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|<div style="background-color: #66FF66; border: 1px solid #808000; padding: 5px; {{border-radius|16px}}" align="right"><font size="4"><b>{{#ask: [[-Has subobject::{{FULLPAGENAME}}]] |?Regimen |limit=10000|format=sum}} regimens on this page</b></font></div>
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<div style="background-color: #66CCFF; border: 1px solid #808000; padding: 5px; {{border-radius|16px}}"><font size="4"><b>{{#ask: [[-Has subobject::{{FULLPAGENAME}}]] |?Variant |limit=10000|format=sum}} variants on this page</b></font></div>
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<div style="background-color: #66CCFF; border: 1px solid #808000; padding: 5px; {{border-radius|16px}}"><font size="4"><b>{{#ask: [[-Has subobject::{{FULLPAGENAME}}]] |?Variant |limit=10000|format=sum}} variants on this page</b></font></div>
 
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border-width:2px;
 
border-width:2px;
 
border-style:solid;">Phase II</span>
 
border-style:solid;">Phase II</span>
−
|-
 
−
!colspan="4" align="center"|
 
 
|-
 
|-
 
|[http://annonc.oxfordjournals.org/content/19/2/370.long Castagneto et al. 2007]
 
|[http://annonc.oxfordjournals.org/content/19/2/370.long Castagneto et al. 2007]
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|-
 
|-
 
|}
 
|}
 +
====Chemotherapy====
 +
*[[Carboplatin (Paraplatin)]] AUC 5 IV over 30 minutes once on day 1, '''given second, 30 minutes after pemetrexed'''
 +
*[[Pemetrexed (Alimta)]] 500 mg/m<sup>2</sup> IV over 10 minutes once on day 1, '''given first'''
  
−
*[[Carboplatin (Paraplatin)]] AUC 5 IV over 30 minutes on day 1, '''given second, 30 minutes after pemetrexed'''
+
====Supportive medications====
−
*[[Pemetrexed (Alimta)]] 500 mg/m2 IV over 10 minutes on day 1, '''given first'''
+
*(varies depending on reference):
−
 
+
*Folic acid 350 to 600 mcg PO once per day, starting at least 1 week before [[Pemetrexed (Alimta)]], to continue throughout therapy
−
Supportive medications (varies depending on reference):
 
−
*Folic acid 350-600 mcg PO daily, starting at least 1 week before [[Pemetrexed (Alimta)]], to continue throughout therapy
 
 
*[[Cyanocobalamin (Vitamin B12)]] 1000 mcg IM once at least 1 week before [[Pemetrexed (Alimta)]], then 1000 mcg to be given every 9 weeks thereafter
 
*[[Cyanocobalamin (Vitamin B12)]] 1000 mcg IM once at least 1 week before [[Pemetrexed (Alimta)]], then 1000 mcg to be given every 9 weeks thereafter
 
*[[Dexamethasone (Decadron)]] 4 mg PO BID the day before, the day of, and day after [[Pemetrexed (Alimta)]]
 
*[[Dexamethasone (Decadron)]] 4 mg PO BID the day before, the day of, and day after [[Pemetrexed (Alimta)]]
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*No NSAIDs (nonsteroidal anti-inflammatory drugs) for 2 days (5 days for NSAIDs with longer half-lives) before or after [[Pemetrexed (Alimta)]]  
 
*No NSAIDs (nonsteroidal anti-inflammatory drugs) for 2 days (5 days for NSAIDs with longer half-lives) before or after [[Pemetrexed (Alimta)]]  
  
−
'''21-day cycles'''; up to 9 cycles in Castagneto et al. 2008
+
'''21-day cycles'''
 +
 
 +
''Up to 9 cycles in Castagneto et al. 2007.''
  
 
===References===
 
===References===
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|-
 
|-
 
|}
 
|}
−
*[[Cisplatin (Platinol)]] 75 mg/m2 IV over 2 hours on day 1
+
====Chemotherapy====
 +
*[[Cisplatin (Platinol)]] 75 mg/m<sup>2</sup> IV over 2 hours once on day 1
  
 
'''21-day cycles'''
 
'''21-day cycles'''
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|-
 
|-
 
|}
 
|}
 +
====Chemotherapy====
 +
*[[Cisplatin (Platinol)]] 100 mg/m<sup>2</sup> IV over 1 hour once on day 1, '''given first'''
 +
*[[Gemcitabine (Gemzar)]] 1000 mg/m<sup>2</sup> IV over 30 minutes once per day on days 1, 8, 15, '''given second'''
  
−
*[[Cisplatin (Platinol)]] 100 mg/m2 IV over 1 hour on day 1, '''given first'''
+
====Supportive medications====
−
*[[Gemcitabine (Gemzar)]] 1000 mg/m2 IV over 30 minutes once per day on days 1, 8, 15, '''given second'''
 
−
 
 
−
Supportive medications:
 
 
*Minimum of 3 liters of IV hydration for [[Cisplatin (Platinol)]], with magnesium supplementation
 
*Minimum of 3 liters of IV hydration for [[Cisplatin (Platinol)]], with magnesium supplementation
 
*[[antiemesis|5HT-3 antagonists & Dexamethasone (Decadron)]] IV once per day on days 1, 8, 15 before chemotherapy
 
*[[antiemesis|5HT-3 antagonists & Dexamethasone (Decadron)]] IV once per day on days 1, 8, 15 before chemotherapy
 
*[[antiemesis|5HT-3 antagonists, Dexamethasone (Decadron), and/or phenothiazines]] for antiemesis PO or by rectal suppository for 3 to 5 days after [[Cisplatin (Platinol)]]
 
*[[antiemesis|5HT-3 antagonists, Dexamethasone (Decadron), and/or phenothiazines]] for antiemesis PO or by rectal suppository for 3 to 5 days after [[Cisplatin (Platinol)]]
  
−
'''28-day cycle x up to 6 cycles'''
+
'''28-day cycle for up to 6 cycles'''
  
 
===Regimen #2 {{#subobject:4dfb66|Variant=1}}===
 
===Regimen #2 {{#subobject:4dfb66|Variant=1}}===
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|-
 
|-
 
|}
 
|}
 +
====Chemotherapy====
 +
*[[Cisplatin (Platinol)]] 80 mg/m<sup>2</sup> IV over 3 hours once on day 1, '''given second'''
 +
*[[Gemcitabine (Gemzar)]] 1250 mg/m<sup>2</sup> IV over 30 minutes once per day on days 1 & 8, '''given first'''
  
−
*[[Cisplatin (Platinol)]] 80 mg/m2 IV over 3 hours on day 1, '''given second'''
+
====Supportive medications====
−
*[[Gemcitabine (Gemzar)]] 1250 mg/m2 IV over 30 minutes once per day on days 1 & 8, '''given first'''
 
−
 
 
−
Supportive medications:
 
 
*Minimum of 2 liters of IV hydration for [[Cisplatin (Platinol)]]
 
*Minimum of 2 liters of IV hydration for [[Cisplatin (Platinol)]]
 
*[[antiemesis|5HT-3 antagonists & corticosteroids]] before [[Cisplatin (Platinol)]]
 
*[[antiemesis|5HT-3 antagonists & corticosteroids]] before [[Cisplatin (Platinol)]]
  
−
'''21-day cycle x up to 6 cycles'''
+
'''21-day cycle for up to 6 cycles'''
  
 
===References===
 
===References===
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border-style:solid;">Phase III</span>
 
border-style:solid;">Phase III</span>
 
|[[Mesothelioma#Cisplatin_.28Platinol.29|Cisplatin]]
 
|[[Mesothelioma#Cisplatin_.28Platinol.29|Cisplatin]]
−
|-
 
−
!colspan="4" align="center"|
 
 
|-
 
|-
 
|[http://meetinglibrary.asco.org/content/150191-156 Zalcman et al. 2015 (IFCT-GFPC-0701 MAPS)]
 
|[http://meetinglibrary.asco.org/content/150191-156 Zalcman et al. 2015 (IFCT-GFPC-0701 MAPS)]
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|-
 
|-
 
|}
 
|}
 +
====Chemotherapy====
 +
*[[Cisplatin (Platinol)]] 75 mg/m<sup>2</sup> IV over 2 hours once on day 1, '''given second, 30 minutes after pemetrexed'''
 +
*[[Pemetrexed (Alimta)]] 500 mg/m<sup>2</sup> IV over 10 minutes once on day 1, '''given first'''
  
−
*[[Cisplatin (Platinol)]] 75 mg/m2 IV over 2 hours on day 1, '''given second, 30 minutes after pemetrexed'''
+
====Supportive medications====
−
*[[Pemetrexed (Alimta)]] 500 mg/m2 IV over 10 minutes on day 1, '''given first'''
+
*Folic acid 350 to 1000 mcg PO once per day, starting 1 to 3 weeks before [[Pemetrexed (Alimta)]], to continue throughout therapy
−
 
 
−
Supportive medications:
 
−
*Folic acid 350-1000 mcg PO daily, starting 1 to 3 weeks before [[Pemetrexed (Alimta)]], to continue throughout therapy
 
 
*[[Cyanocobalamin (Vitamin B12)]] 1000 mcg IM once 1 to 3 weeks before [[Pemetrexed (Alimta)]], then 1000 mcg to be given every 9 weeks thereafter
 
*[[Cyanocobalamin (Vitamin B12)]] 1000 mcg IM once 1 to 3 weeks before [[Pemetrexed (Alimta)]], then 1000 mcg to be given every 9 weeks thereafter
 
*[[Dexamethasone (Decadron)]] (dose not specified by reference) the day before, the day of, and day after [[Pemetrexed (Alimta)]]
 
*[[Dexamethasone (Decadron)]] (dose not specified by reference) the day before, the day of, and day after [[Pemetrexed (Alimta)]]
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|[[#toc|back to top]]
 
|[[#toc|back to top]]
 
|}
 
|}
−
 
 
MVP: '''<u>M</u>'''itomycin, '''<u>V</u>'''inblastine, '''<u>P</u>'''latinol (Cisplatin)
 
MVP: '''<u>M</u>'''itomycin, '''<u>V</u>'''inblastine, '''<u>P</u>'''latinol (Cisplatin)
  
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|-
 
|-
 
|}
 
|}
 +
====Chemotherapy====
 +
*[[Pemetrexed (Alimta)]] 500 mg/m<sup>2</sup> IV over 10 minutes once on day 1
  
−
*[[Pemetrexed (Alimta)]] 500 mg/m2 IV over 10 minutes on day 1
+
====Supportive medications====
−
 
+
*Folic acid 350 to 600 mcg PO once per day, starting 1 to 2 weeks before pemetrexed, to continue throughout therapy and at least 3 weeks after the last dose of [[Pemetrexed (Alimta)]]
−
Supportive medications:
+
*[[Cyanocobalamin (Vitamin B12)]] 1000 mcg IM once 1 to 2 weeks before [[Pemetrexed (Alimta)]], then 1000 mcg to be given every 9 weeks thereafter while continuing on pemetrexed therapy
−
*Folic acid 350-600 mcg PO daily, starting 1-2 weeks before pemetrexed, to continue throughout therapy and at least 3 weeks after the last dose of [[Pemetrexed (Alimta)]]
 
−
*[[Cyanocobalamin (Vitamin B12)]] 1000 mcg IM once 1-2 weeks before [[Pemetrexed (Alimta)]], then 1000 mcg to be given every 9 weeks thereafter while continuing on pemetrexed therapy
 
 
*[[Dexamethasone (Decadron)]] 4 mg PO BID the day before, the day of, and day after [[Pemetrexed (Alimta)]]
 
*[[Dexamethasone (Decadron)]] 4 mg PO BID the day before, the day of, and day after [[Pemetrexed (Alimta)]]
  
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|}
 
|}
  
−
''Note: The NCCN, Malignant Pleural Mesothelioma version 2.2012, lists the [[Vinorelbine (Navelbine)]] dosage as 25-30 mg/m2. No primary reference could be found for the 25 mg/m2 dosage.''
+
''Note: The NCCN, Malignant Pleural Mesothelioma version 2.2012, lists the [[Vinorelbine (Navelbine)]] dosage as 25 to 30 mg/m<sup>2</sup>. No primary reference could be found for the 25 mg/m<sup>2</sup> dosage.''
−
*[[Vinorelbine (Navelbine)]] 30 mg/m2 IV once per week x 12 weeks, with a 2-week treatment-free gap between the 6th and 7th doses
+
====Chemotherapy====
 +
*[[Vinorelbine (Navelbine)]] 30 mg/m<sup>2</sup> IV once per week x 12 weeks, with a 2-week treatment-free gap between the 6th and 7th doses
  
 
'''12-week course'''
 
'''12-week course'''
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# Jassem J, Ramlau R, Santoro A, Schuette W, Chemaissani A, Hong S, Blatter J, Adachi S, Hanauske A, Manegold C. Phase III trial of pemetrexed plus best supportive care compared with best supportive care in previously treated patients with advanced malignant pleural mesothelioma. J Clin Oncol. 2008 Apr 1;26(10):1698-704. [http://jco.ascopubs.org/content/26/10/1698.long link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/18375898 PubMed]
 
# Jassem J, Ramlau R, Santoro A, Schuette W, Chemaissani A, Hong S, Blatter J, Adachi S, Hanauske A, Manegold C. Phase III trial of pemetrexed plus best supportive care compared with best supportive care in previously treated patients with advanced malignant pleural mesothelioma. J Clin Oncol. 2008 Apr 1;26(10):1698-704. [http://jco.ascopubs.org/content/26/10/1698.long link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/18375898 PubMed]
  
−
==Gemcitabine (Gemzar) {{#subobject:cc9029|Regimen=1}}==
+
==Gemcitabine (Gemzar)==
 
{| class="wikitable" style="float:right; margin-left: 5px;"
 
{| class="wikitable" style="float:right; margin-left: 5px;"
 
|-
 
|-
 
|[[#toc|back to top]]
 
|[[#toc|back to top]]
 
|}
 
|}
−
''Note: The NCCN, Malignant Pleural Mesothelioma version 2.2012, lists [[Gemcitabine (Gemzar)]] as a second-line monotherapy treatment option, but the listed reference did not provide details about its administration. No primary reference could be found for dosing of [[Gemcitabine (Gemzar)]] monotherapy in this setting, although its use is described in Manegold et al. 2005.''
+
''Note: The NCCN, Malignant Pleural Mesothelioma version 2.2012, lists [[Gemcitabine (Gemzar)]] as a second-line monotherapy treatment option, but the listed reference did not provide details about its administration. No primary reference could be found for dosing of [[Gemcitabine (Gemzar)]] monotherapy in this setting, although its use is described in the first line, where it has been generally ineffective.''
−
 
 
−
===Regimen {{#subobject:a8817b|Variant=1}}===
 
  
 
===References===
 
===References===
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|-
 
|-
 
|}
 
|}
 +
====Chemotherapy====
 +
*[[Pemetrexed (Alimta)]] 500 mg/m<sup>2</sup> IV over 10 minutes once on day 1
  
−
*[[Pemetrexed (Alimta)]] 500 mg/m2 IV over 10 minutes on day 1
+
====Supportive medications====
−
 
+
*Folic acid 350 to 1000 mcg PO once per day, starting 1 to 2 weeks before [[Pemetrexed (Alimta)]], to continue throughout therapy and at least 3 weeks after the last dose of pemetrexed
−
Supportive medications:
+
*[[Cyanocobalamin (Vitamin B12)]] 1000 mcg IM once 1 to 2 weeks before [[Pemetrexed (Alimta)]], then 1000 mcg to be given every 9 weeks thereafter while continuing on pemetrexed therapy
−
*Folic acid 350-1000 mcg PO daily, starting 1-2 weeks before [[Pemetrexed (Alimta)]], to continue throughout therapy and at least 3 weeks after the last dose of pemetrexed
 
−
*[[Cyanocobalamin (Vitamin B12)]] 1000 mcg IM once 1-2 weeks before [[Pemetrexed (Alimta)]], then 1000 mcg to be given every 9 weeks thereafter while continuing on pemetrexed therapy
 
 
*[[Dexamethasone (Decadron)]] 4 mg PO BID the day before, the day of, and day after [[Pemetrexed (Alimta)]]
 
*[[Dexamethasone (Decadron)]] 4 mg PO BID the day before, the day of, and day after [[Pemetrexed (Alimta)]]
  
−
'''21-day cycle x 8 or more cycles'''
+
'''21-day cycle for 8 or more cycles'''
  
 
===References===
 
===References===
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|-
 
|-
 
|}
 
|}
−
*[[Vinorelbine (Navelbine)]] 30 mg/m2 (maximum of 60 mg per dose) IV over 5 minutes once per day on days 1, 8, 15, 22, 29, 36  
+
====Chemotherapy====
 +
*[[Vinorelbine (Navelbine)]] 30 mg/m<sup>2</sup> (maximum of 60 mg per dose) IV over 5 minutes once per day on days 1, 8, 15, 22, 29, 36  
  
 
'''42-day cycles'''
 
'''42-day cycles'''
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===References===
 
===References===
 
# Stebbing J, Powles T, McPherson K, Shamash J, Wells P, Sheaff MT, Slater S, Rudd RM, Fennell D, Steele JP. The efficacy and safety of weekly vinorelbine in relapsed malignant pleural mesothelioma. Lung Cancer. 2009 Jan;63(1):94-7. Epub 2008 May 16. [http://www.lungcancerjournal.info/article/S0169-5002%2808%2900194-3/abstract link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/18486273 PubMed]
 
# Stebbing J, Powles T, McPherson K, Shamash J, Wells P, Sheaff MT, Slater S, Rudd RM, Fennell D, Steele JP. The efficacy and safety of weekly vinorelbine in relapsed malignant pleural mesothelioma. Lung Cancer. 2009 Jan;63(1):94-7. Epub 2008 May 16. [http://www.lungcancerjournal.info/article/S0169-5002%2808%2900194-3/abstract link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/18486273 PubMed]
 +
 +
[[Category:Chemotherapy regimens]]
 +
[[Category:Solid oncology regimens]]

Revision as of 00:08, 19 August 2016

Use of this site is subject to you reading and agreeing with the terms set forth in the disclaimer.

Is there a regimen missing from this list? Would you like to share a different dosage/schedule or an additional reference for a regimen? Have you noticed an error? Do you have an idea that will help the site grow to better meet your needs and the needs of many others? You are invited to contribute to the site.

19 regimens on this page
33 variants on this page


First-line therapy

Active symptom control

back to top

Regimen

Study Evidence Comparator
Muers et al. (MS01) Phase III MVP
Vinorelbine

No antineoplastic treatment; used as a comparator arm and here for reference purposes only.

References

  1. Muers MF, Stephens RJ, Fisher P, Darlison L, Higgs CM, Lowry E, Nicholson AG, O'Brien M, Peake M, Rudd R, Snee M, Steele J, Girling DJ, Nankivell M, Pugh C, Parmar MK; MS01 Trial Management Group. Active symptom control with or without chemotherapy in the treatment of patients with malignant pleural mesothelioma (MS01): a multicentre randomised trial. Lancet. 2008 May 17;371(9625):1685-94. link to PMC article contains verified protocol PubMed

Carboplatin & Pemetrexed

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Regimen

Study Evidence
Ceresoli et al. 2006 Phase II
Castagneto et al. 2007 Phase II

Chemotherapy

Supportive medications

21-day cycles

Up to 9 cycles in Castagneto et al. 2007.

References

  1. Ceresoli GL, Zucali PA, Favaretto AG, Grossi F, Bidoli P, Del Conte G, Ceribelli A, Bearz A, Morenghi E, Cavina R, Marangolo M, Parra HJ, Santoro A. Phase II study of pemetrexed plus carboplatin in malignant pleural mesothelioma. J Clin Oncol. 2006 Mar 20;24(9):1443-8. link to original article contains verified protocol PubMed
  2. Castagneto B, Botta M, Aitini E, Spigno F, Degiovanni D, Alabiso O, Serra M, Muzio A, Carbone R, Buosi R, Galbusera V, Piccolini E, Giaretto L, Rebella L, Mencoboni M. Phase II study of pemetrexed in combination with carboplatin in patients with malignant pleural mesothelioma (MPM). Ann Oncol. 2008 Feb;19(2):370-3. Epub 2007 Dec 20. link to original article contains verified protocol PubMed

Cisplatin (Platinol)

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Regimen

Study Evidence Comparator
Vogelzang et al. 2003 Phase III Cisplatin & Pemetrexed

Chemotherapy

21-day cycles

References

  1. Vogelzang NJ, Rusthoven JJ, Symanowski J, Denham C, Kaukel E, Ruffie P, Gatzemeier U, Boyer M, Emri S, Manegold C, Niyikiza C, Paoletti P. Phase III study of pemetrexed in combination with cisplatin versus cisplatin alone in patients with malignant pleural mesothelioma. J Clin Oncol. 2003 Jul 15;21(14):2636-44. link to original article contains verified protocol PubMed
    1. Update: Manegold C, Symanowski J, Gatzemeier U, Reck M, von Pawel J, Kortsik C, Nackaerts K, Lianes P, Vogelzang NJ. Second-line (post-study) chemotherapy received by patients treated in the phase III trial of pemetrexed plus cisplatin versus cisplatin alone in malignant pleural mesothelioma. Ann Oncol. 2005 Jun;16(6):923-7. Epub 2005 Apr 11. link to original article PubMed

Cisplatin & Gemcitabine

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Regimen #1

Study Evidence
Nowak et al. 2002 Phase II

Chemotherapy

Supportive medications

28-day cycle for up to 6 cycles

Regimen #2

Study Evidence
van Haarst et al. 2002 Phase II

Chemotherapy

Supportive medications

21-day cycle for up to 6 cycles

References

  1. van Haarst JM, Baas P, Manegold Ch, Schouwink JH, Burgers JA, de Bruin HG, Mooi WJ, van Klaveren RJ, de Jonge MJ, van Meerbeeck JP. Multicentre phase II study of gemcitabine and cisplatin in malignant pleural mesothelioma. Br J Cancer. 2002 Feb 1;86(3):342-5. link to original article contains verified protocol PubMed content property of HemOnc.org
  2. Nowak AK, Byrne MJ, Williamson R, Ryan G, Segal A, Fielding D, Mitchell P, Musk AW, Robinson BW. A multicentre phase II study of cisplatin and gemcitabine for malignant mesothelioma. Br J Cancer. 2002 Aug 27;87(5):491-6. link to original article contains verified protocol PubMed

Cisplatin & Pemetrexed

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Regimen

Study Evidence Comparator
Vogelzang et al. 2003 Phase III Cisplatin
Zalcman et al. 2015 (IFCT-GFPC-0701 MAPS) Phase III Cisplatin, Pemetrexed, Bevacizumab

Chemotherapy

Supportive medications

21-day cycles

References

  1. Vogelzang NJ, Rusthoven JJ, Symanowski J, Denham C, Kaukel E, Ruffie P, Gatzemeier U, Boyer M, Emri S, Manegold C, Niyikiza C, Paoletti P. Phase III study of pemetrexed in combination with cisplatin versus cisplatin alone in patients with malignant pleural mesothelioma. J Clin Oncol. 2003 Jul 15;21(14):2636-44. link to original article contains verified protocol PubMed
    1. Update: Manegold C, Symanowski J, Gatzemeier U, Reck M, von Pawel J, Kortsik C, Nackaerts K, Lianes P, Vogelzang NJ. Second-line (post-study) chemotherapy received by patients treated in the phase III trial of pemetrexed plus cisplatin versus cisplatin alone in malignant pleural mesothelioma. Ann Oncol. 2005 Jun;16(6):923-7. Epub 2005 Apr 11. link to original article PubMed
  2. Abstract: Gerard Zalcman, Julien Mazières, Jacques Margery, Laurent Greillier, Clarisse Audigier-Valette, Denis Moro-Sibilot, Oliver Molinier, Romain Corre, Isabelle Monnet, Valérie Gounant, Henri Janicot, Radj Gervais, Chrystele Locher, Bernard Milleron, Quan Tran, Marie Paule Lebitasy, Franck Morin, Christian Creveuil, Jean-Jacques Parienti, Arnaud Scherpereel, French Cooperative Thoracic Intergroup (IFCT). Bevacizumab 15mg/kg plus cisplatin-pemetrexed (CP) triplet versus CP doublet in Malignant Pleural Mesothelioma (MPM): Results of the IFCT-GFPC-0701 MAPS randomized phase 3 trial. J Clin Oncol 33, 2015 (suppl; abstr 7500) link to abstract

MVP

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MVP: Mitomycin, Vinblastine, Platinol (Cisplatin)

Regimen

Study Evidence Comparator
Muers et al. (MS01) Phase III Active symptom control
Vinorelbine

Not considered a standard of care, included because it was a comparator arm.

References

  1. Muers MF, Stephens RJ, Fisher P, Darlison L, Higgs CM, Lowry E, Nicholson AG, O'Brien M, Peake M, Rudd R, Snee M, Steele J, Girling DJ, Nankivell M, Pugh C, Parmar MK; MS01 Trial Management Group. Active symptom control with or without chemotherapy in the treatment of patients with malignant pleural mesothelioma (MS01): a multicentre randomised trial. Lancet. 2008 May 17;371(9625):1685-94. link to PMC article PubMed

Pemetrexed (Alimta)

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Regimen

Study Evidence
Taylor et al. 2008 Phase II

Chemotherapy

Supportive medications

21-day cycles

References

  1. Taylor P, Castagneto B, Dark G, Marangolo M, Scagliotti GV, van Klaveren RJ, Labianca R, Serke M, Schuette W, van Meerbeeck JP, Heigener D, Liu Y, Adachi S, Blatter J, von Pawel J. Single-agent pemetrexed for chemonaïve and pretreated patients with malignant pleural mesothelioma: results of an International Expanded Access Program. J Thorac Oncol. 2008 Jul;3(7):764-71. link to original article contains verified protocol PubMed

Vinorelbine (Navelbine)

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Regimen

Study Evidence Comparator
Muers et al. (MS01) Phase III Active symptom control
MVP

Note: The NCCN, Malignant Pleural Mesothelioma version 2.2012, lists the Vinorelbine (Navelbine) dosage as 25 to 30 mg/m2. No primary reference could be found for the 25 mg/m2 dosage.

Chemotherapy

  • Vinorelbine (Navelbine) 30 mg/m2 IV once per week x 12 weeks, with a 2-week treatment-free gap between the 6th and 7th doses

12-week course

References

  1. Muers MF, Stephens RJ, Fisher P, Darlison L, Higgs CM, Lowry E, Nicholson AG, O'Brien M, Peake M, Rudd R, Snee M, Steele J, Girling DJ, Nankivell M, Pugh C, Parmar MK; MS01 Trial Management Group. Active symptom control with or without chemotherapy in the treatment of patients with malignant pleural mesothelioma (MS01): a multicentre randomised trial. Lancet. 2008 May 17;371(9625):1685-94. link to original article contains verified protocol PubMed

Second-line therapy

Best supportive care

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Regimen

Study Evidence Comparator
Jassem et al. 2008 Phase III Pemetrexed

No antineoplastic treatment; used as a comparator arm and here for reference purposes only.

References

  1. Jassem J, Ramlau R, Santoro A, Schuette W, Chemaissani A, Hong S, Blatter J, Adachi S, Hanauske A, Manegold C. Phase III trial of pemetrexed plus best supportive care compared with best supportive care in previously treated patients with advanced malignant pleural mesothelioma. J Clin Oncol. 2008 Apr 1;26(10):1698-704. link to original article contains verified protocol PubMed

Gemcitabine (Gemzar)

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Note: The NCCN, Malignant Pleural Mesothelioma version 2.2012, lists Gemcitabine (Gemzar) as a second-line monotherapy treatment option, but the listed reference did not provide details about its administration. No primary reference could be found for dosing of Gemcitabine (Gemzar) monotherapy in this setting, although its use is described in the first line, where it has been generally ineffective.

References

  1. Manegold C, Symanowski J, Gatzemeier U, Reck M, von Pawel J, Kortsik C, Nackaerts K, Lianes P, Vogelzang NJ. Second-line (post-study) chemotherapy received by patients treated in the phase III trial of pemetrexed plus cisplatin versus cisplatin alone in malignant pleural mesothelioma. Ann Oncol. 2005 Jun;16(6):923-7. Epub 2005 Apr 11. link to original article PubMed

Pemetrexed (Alimta)

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Regimen

Study Evidence Comparator
Jassem et al. 2008 Phase III Best supportive care

Chemotherapy

Supportive medications

21-day cycle for 8 or more cycles

References

  1. Jassem J, Ramlau R, Santoro A, Schuette W, Chemaissani A, Hong S, Blatter J, Adachi S, Hanauske A, Manegold C. Phase III trial of pemetrexed plus best supportive care compared with best supportive care in previously treated patients with advanced malignant pleural mesothelioma. J Clin Oncol. 2008 Apr 1;26(10):1698-704. link to original article contains verified protocol PubMed

Vinorelbine (Navelbine)

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Regimen

Study Evidence
Stebbing et al. 2008 Phase II

Chemotherapy

  • Vinorelbine (Navelbine) 30 mg/m2 (maximum of 60 mg per dose) IV over 5 minutes once per day on days 1, 8, 15, 22, 29, 36

42-day cycles

References

  1. Stebbing J, Powles T, McPherson K, Shamash J, Wells P, Sheaff MT, Slater S, Rudd RM, Fennell D, Steele JP. The efficacy and safety of weekly vinorelbine in relapsed malignant pleural mesothelioma. Lung Cancer. 2009 Jan;63(1):94-7. Epub 2008 May 16. link to original article contains verified protocol PubMed
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