Clinical Features and Treatment Outcome of Malignant Pleural Mesothelioma

Manlio Mencoboni, Rosa A Filiberti, Paola Taveggia, Federica Grosso, Giulia Pasello, Lisette Del Corso, Alberto Muzio, Valentina Polo, Paolo Zucali, Giovanni L Ceresoli, Hector J Soto Parra, Laura Auriati, Claudio Simonassi

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BACKGROUND: Malignant pleural mesothelioma is a problematic condition due to poor prognosis and difficulties in management. We evaluated the treatment and outcome of 378 mesothelioma patients referred to 6 Italian Oncology Departments.

METHODS: Demographic and clinical data were collected. Treatment was assessed in terms of chemotherapy (line of treatment, pemetrexed-based regimen, other therapies), surgery, and radiotherapy. Response to therapy, progression-free survival, and overall survival were evaluated.

RESULTS: 36 and 342 patients received best supportive care and active treatment, respectively; 86 patients underwent surgery, and 26 received trimodal therapy. Disease control after first-line chemotherapy was achieved in 74.2% of patients (75.7% in patients treated with pemetrexed combined with other drugs and 69% with pemetrexed as monotherapy). The disease control rate was 82.6% in pemetrexed re-challenged individuals. Median survival time was 11.6 months with supportive care, 16.2 months with chemotherapy only, 32.4 months with surgery plus chemotherapy, and 47.2 months with trimodal therapy. A more favorable prognosis was observed in responders to first-line therapy who were then actively treated with second-line (24.8 vs. 11.8 months in non-responders, p < 0.001) and third-line chemotherapy (28.9 vs. 17.8 months in non-responders, p = 0.005).

CONCLUSION: Mesothelioma patients benefited from chemotherapy alone only when retreated in the second line after response to first-line therapy.

Original languageEnglish
Pages (from-to)364-369
Number of pages6
JournalOncology Research and Treatment
Issue number6
Publication statusPublished - 2017


  • Journal Article


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