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. 2008 Jul 8;99(1):51-6.
doi: 10.1038/sj.bjc.6604442. Epub 2008 Jun 10.

Pemetrexed plus carboplatin in elderly patients with malignant pleural mesothelioma: combined analysis of two phase II trials

G L Ceresoli  1 , B Castagneto, P A Zucali, A Favaretto, M Mencoboni, F Grossi, D Cortinovis, G Del Conte, A Ceribelli, A Bearz, S Salamina, F De Vincenzo, F Cappuzzo, M Marangolo, V Torri, A Santoro
Affiliations

Pemetrexed plus carboplatin in elderly patients with malignant pleural mesothelioma: combined analysis of two phase II trials

G L Ceresoli et al. Br J Cancer. .

Abstract

The incidence of malignant pleural mesothelioma (MPM) in elderly patients is increasing. In this study, pooled data from two phase II trials of pemetrexed and carboplatin (PC) as first-line therapy were retrospectively analysed for comparisons between age groups. Patients received pemetrexed 500 mg m(-2) and carboplatin AUC 5 mg ml(-1) min(-1) intravenously every 21 days with standard vitamin supplementation. Elderly patients were defined as those >or=70 years old. A total of 178 patients with an ECOG performance status of <or=2 were included. Median age was 65 years (range 38-79), with 48 patients >or=70 years (27%). Grade 3-4 haematological toxicity was slightly worse in >or=70 vs <70-year-old patients, with neutropenia observed in 25.0 vs 13.8% (P=0.11), anaemia in 20.8 vs 6.9% (P=0.01) and thrombocytopenia in 14.6 vs 8.5% (P=0.26). Non-haematological toxicity was mild and similar in the two groups. No significant difference was observed in terms of overall disease control (60.4 vs 66.9%, P=0.47), time to progression (7.2 vs 7.5 months, P=0.42) and survival (10.7 vs 13.9 months, P=0.12). Apart from slightly worse haematological toxicity, there was no significant difference in outcome or toxicity between age groups. The PC regimen is effective and well tolerated in selected elderly patients with MPM.

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Figures

Figure 1
Figure 1
Therapeutic management of the total population of chemo-naive patients with malignant pleural mesothelioma (MPM) referred to the participating centres during the study period. Patients aged ⩾70 years represented 34% (98 of 298) of new cases of MPM.
Figure 2
Figure 2
Kaplan–Meier curve of time to disease progression for younger (solid line) and elderly (dotted line) patients (P=0.42).
Figure 3
Figure 3
Kaplan–Meier curve of overall survival time for younger (solid line) and elderly (dotted line) patients (P=0.12).
See this image and copyright information in PMC

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