Ifosfamide and adriamycin combination in the treatment of diffuse malignant mesothelioma

ABSTRACT

In a pilot study [Jan.-Dec. 1989], twenty cases of diffuse malignant mesothelioma were treated in NEMROCK by a combination of ifosfamide and adriamycin. All patients were evaluable for treatment response, toxicity and survival data. The chemotherapy program consisted of ifosfamide 1.25 gm/m-/d x 4 days [given with Mesna as 20% of ifosfamide dose on hours 0, 4, 8/d] and adriamycin 50 mg/m on day 5. Treatment was repeated on 4 weekly basis till progression or to a total of six cycles. None of the 20 patients achieved complete remission, while 5 cases [25%] had partial response [PR] for a median duration of 14 months. Four cases [20%] had minimal response, while 7 cases [35%] had stable disease [SD] and 4 cases [20%] had disease progression [DP]. The mean survival time was 20.7 months for PR+MR versus 6.6 months for SD+DP [P<0.00001]. Fifty percent of the cases experienced complete symptomatic relief with definite improvement of their pretreatment performance status [P.S.]. Toxicity was generally mild to moderate being nausea and vomiting [100%], alopecia [100%], haematologic [40%] and mild infection. No grade 4 toxicity was observed. Multivariate analysis showed that response to treatment, symptomatic relief, early stage, younger age and good P.S. were associated with improved survival