|Patients: This phase 2 study involved 77 patients with stage I, II, or III malignant pleural mesothelioma. The median age was 63, ranging from 34 to 78 years of age. There were 56 men and 21 women in this study.
Treatment: Patients were treated with the chemotherapy drugs cisplatin and pemetrexed. They also received surgery (extrapleural pneumonectomy) and radiation therapy. Of the 77 patients in this study that received chemotherapy, 57 also received surgery and 44 received radiation therapy.
Toxicity: Following chemotherapy, there were two reports of grade 4 pulmonary embolisms and one report each of grade 4 febrile neutropenia, neutropenia, and chest pain. Almost 4% of the patients experienced grade 3 or 4 neutropenia and febrile neutropenia occurred in 2.6% of patients. Grade 3 pneumonia was reported in 5.2% of patients. Following surgery, grade 3 or 4 atrial fibrillation, pain, dyspnea, anemia, and sepsis were reported. Of these, atrial fibrillation was the most common, reported in 10.5% of patients. Following radiation, two patients had gastrointestinal toxicity, one patient each had a toxicity affecting the larynx, lung, and skin.
Results: The median overall survival for all patients, regardless of how much of the therapy was completed, was 16.8 months. Among patients that received surgery, median survival was 21.9 months. Among those that also received radiation therapy, median survival was 29.1 months.
Support: This study was supported by research funds from Eli Lilly, which markets pemetrexed as Alimta®.
Correspondence: Dr. Lee M. Krug