First line chemo for mesothelioma
For first line unresectable pleural mesothelioma, NCCN recommends: Alimta and carboplatin or cisplatin every 3 weeks as a Category 1 recommendation. In various studies, these combinations obtained overall response rate of 26.3% in 745 mesothelioma patients, and the combination of pemetrexed and carboplatin was associated with an overall response rate of 21.6%. One-year survival rate was 63 to 64%. The researchers’ findings were derived from an analysis of outcome data on 1,704 chemotherapy-naive patients.
If not these drugs, NCCN also advises gemcitabine/cisplatin or Alimta or vinorelbine as a single agent. The role of Avastin in mesothelioma is not defined and not well studied. It is in an ongoign French study: A Phase II-III Randomized Trial Pemetrexed-Cisplatin Chemotherapy With or Without Bevacizumab (Avastin), 15 mg/kg, for Malignant Pleural Mesothelioma (MPM), NCT00651456.
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