Response to chemotherapy is predictive in relation to longer overall survival in an individual patient combined-analysis with pleural mesothelioma

Jaine K. Blayney, Giovanni L. Ceresoli, Bruno Castagneto, Mary E R O'Brien, Baktiar Hasan, Richard Sylvester, Robin Rudd, Jeremy Steele, Sara Busacca, Camillo Porta, Luciano Mutti, Kenneth J. O'Byrne, Paula Scullin, Rabab Gaafar, Paul Baas, Jan Van Meerbeeck, Dean A. Fennell

Research output: Contribution to journalArticle

Abstract

Background: There is currently no early predictive marker of survival for patients receiving chemotherapy for malignant pleural mesothelioma (MPM). Tumour response may be predictive for overall survival (OS), though this has not been explored. We have thus undertaken a combined-analysis of OS, from a 42 day landmark, of 526 patients receiving systemic therapy for MPM. We also validate published progression-free survival rates (PFSRs) and a progression-free survival (PFS) prognostic-index model. Methods: Analyses included nine MPM clinical trials incorporating six European Organisation for Research and Treatment of Cancer (EORTC) studies. Analysis of OS from landmark (from day 42 post-treatment) was considered regarding tumour response. PFSR analysis data included six non-EORTC MPM clinical trials. Prognostic index validation was performed on one non-EORTC data-set, with available survival data. Results: Median OS, from landmark, of patients with partial response (PR) was 12·8 months, stable disease (SD), 9·4 months and progressive disease (PD), 3·4 months. Both PR and SD were associated with longer OS from landmark compared with disease progression (both p <0·0001). PFSRs for platinum-based combination therapies were consistent with published significant clinical activity ranges. Effective separation between PFS and OS curves provided a validation of the EORTC prognostic model, based on histology, stage and performance status. Conclusion: Response to chemotherapy is associated with significantly longer OS from landmark in patients with MPM.

Original languageEnglish
Pages (from-to)2983-2992
Number of pages10
JournalEuropean Journal of Cancer
Volume48
Issue number16
DOIs
Publication statusPublished - Nov 2012

Keywords

  • Landmark analysis
  • Mesothelioma
  • Prognosis
  • Survival

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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  • Cite this

    Blayney, J. K., Ceresoli, G. L., Castagneto, B., O'Brien, M. E. R., Hasan, B., Sylvester, R., Rudd, R., Steele, J., Busacca, S., Porta, C., Mutti, L., O'Byrne, K. J., Scullin, P., Gaafar, R., Baas, P., Van Meerbeeck, J., & Fennell, D. A. (2012). Response to chemotherapy is predictive in relation to longer overall survival in an individual patient combined-analysis with pleural mesothelioma. European Journal of Cancer, 48(16), 2983-2992. https://doi.org/10.1016/j.ejca.2012.05.018