Cisplatin/pemetrexed chemotherapy versus palliative care survival in malignant pleural mesothelioma

Introduction: Malignant pleural mesothelioma is a rare tumour commonly associated with asbestos exposure however with increasing incidence and poor survival. The standard first-line chemotherapy regimen is the combination of cisplatin and pemetrexed, with median overall survival of 13 months. Other therapeutic options like surgery, radiation and immunotherapy are currently limited therefore patient s performance status and histological subtype are the only prognostic factors (Scherpereel A. et al. EurRespir J 2010;35: 479-95, Scherpereel A. EurRespir J.2017 Mar 15;49(3). Aim and Objectives: The aim of study was to compare the patient9s survival depending on whether they received chemotherapy or not. Methods: We identified retrospectively 24 patients diagnosed with pleural mesothelioma in Department of Pulmonology, Clinical Hospital Center Split, Croatia evaluating their management, whether they were treated by cisplatin/pemetrexed or solely palliative care as a result of poor performance status or refusal of any specific treatment. Kaplan-Meier survival analysis was used (MedCalc Software ver. 18). Results: The overall median survival (OS) time was 14,6 months. A pronounced OS benefit for palliative care versus cisplatin/pemetrexed was observed, 17 vs 8 months, respectively; HR, 0,3665 ; 95% CI, 0,14 to 0,90 ; P = 0,0047, Fig. 1. Conclusions: Chemotherapeutic treatment did not show better outcomes than solely palliative treatment. Future prospective randomized controlled studies are necessary to optimize the treatment of malignant mesothelioma.