Population-based survival for malignant mesothelioma after introduction of novel chemotherapy

Quoted from http://erj.ersjournals.com/content/40/1/185.abstract

Population-based survival for malignant mesothelioma after introduction of novel chemotherapy

  1. Ronald A.M. Damhuis*?,
  2. Caroline Schroten* and
  3. Jacobus A. Burgers#

+ Author Affiliations

  1. *Rotterdam Cancer Registry, Rotterdam
  2. #Dept of Thoracic Oncology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
  1. R.A. Damhuis, Rotterdam Cancer Registry, P.O. Box 289, 3000 AG Rotterdam, The Netherlands. E-mail: R.Damhuis@iknl.nl

Abstract

Malignant mesothelioma is known for its dismal prognosis and poor response to conventional treatment. Chemotherapy with cisplatin–antifolate combinations recently showed promising response rates and prolonged survival in randomised trials.

To assess the impact of this development on clinical practice and survival at a population-based level, treatment patterns and survival trends were studied for patients diagnosed with mesothelioma in the period 1995–2006. 4,731 records were retrieved from the Netherlands Cancer Registry and chemotherapy use and median survival were analysed.

For the periods 1995–1998 to 2005–2006, chemotherapy use increased from 8% to 36%. Median survival increased over time from 7.1 months to 9.2 months. For pleural mesothelioma, multivariable analysis demonstrated that survival was poorer for elderly patients and sarcomatoid tumours. The prognostic impact of chemotherapy increased with time. Median survival for chemotherapy treated patients improved from 10.1 months (1995–1998) to 13.1 months (2005–2006). For peritoneal mesothelioma, median survival was poor (3.9 months) but better for females and younger patients.

This study demonstrates that chemotherapy use increased at a national level and coincided with an improvement in survival. The novel chemotherapy regimen appears to be more effective but, due to the observational nature of this study, alternative explanations cannot be excluded.

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