ABSTRACT
Mesothelioma is a rare and aggressive tumour with dismal prognosis arising in the pleura and associated with asbestos exposure. Its incidence is on the rise worldwide. In selected patients with early-stage MPM, a maximal surgical cytoreduction in combination with additional antitumour treatment may be considered in selected patients assessed by a multidisciplinary tumor board. In patients with unresectable or advanced MPM, chemotherapy with platinum plus pemetrexed is the standard of care. Currently, no standard salvage therapy has been approved yet, but second-line chemotherapy with vinorelbine or gemcitabine is commonly used. Novel therapeutic approaches based on dual immunotherapy or chemotherapy plus immunotherapy demonstrated promising survival benefit and will probably be incorporated in the future (AU)
Subject(s)
Humans , Pleural Neoplasms/diagnosis , Pleural Neoplasms/therapy , Neoplasm Staging , Societies, Medical , SpainABSTRACT
Mesothelioma is a rare and aggressive tumour with dismal prognosis arising in the pleura and associated with asbestos exposure. Its incidence is on the rise worldwide. In selected patients with early-stage MPM, a maximal surgical cytoreduction in combination with additional antitumour treatment may be considered in selected patients assessed by a multidisciplinary tumor board. In patients with unresectable or advanced MPM, chemotherapy with platinum plus pemetrexed is the standard of care. Currently, no standard salvage therapy has been approved yet, but second-line chemotherapy with vinorelbine or gemcitabine is commonly used. Novel therapeutic approaches based on dual immunotherapy or chemotherapy plus immunotherapy demonstrated promising survival benefit and will probably be incorporated in the future.
Subject(s)
Mesothelioma, Malignant/diagnosis , Mesothelioma, Malignant/therapy , Pleural Neoplasms/diagnosis , Pleural Neoplasms/therapy , Antineoplastic Agents/therapeutic use , Asbestos/toxicity , Carcinogens/toxicity , Combined Modality Therapy/methods , Cytoreduction Surgical Procedures , Deoxycytidine/analogs & derivatives , Deoxycytidine/therapeutic use , Genetic Testing , High-Throughput Nucleotide Sequencing , Humans , Immunotherapy/methods , Medical Oncology , Mesothelioma, Malignant/etiology , Mesothelioma, Malignant/pathology , Neoplasm Staging , Pemetrexed/therapeutic use , Platinum Compounds/therapeutic use , Pleural Neoplasms/etiology , Pleural Neoplasms/pathology , Radiotherapy/methods , Societies, Medical , Spain , Vinorelbine/therapeutic use , GemcitabineABSTRACT
BACKGROUND/AIM: First-line bevacizumab-based therapies have been shown to improve clinical outcomes in patients with non-squamous non-small-cell lung cancer (NSCLC). We aimed to descriptively analyse patients with non-squamous NSCLC who received a long-term period of maintenance bevacizumab. PATIENTS AND METHODS: This retrospective study included 104 patients who had already reached a progression-free survival (PFS) of at least 9 months. RESULTS: Median overall survival and PFS were 30.7 and 15.1 months, respectively. The overall response rate was 83 %. Weight loss ≤5 %, ECOG PS = 0, or low number of metastatic sites seem to be predictive factors of good evolution. The incidence of bevacizumab-related adverse events appeared to be similar as the previous studies. CONCLUSION: Our findings show that there is a long-term survivor group whom the administration of bevacizumab resulted in a relevant prolongation of response without new safety signals. Due to the population heterogeneity, it was not possible to identify the standardised predictive factors.
