Pathological complete response in malignant pleural mesothelioma patients following induction chemotherapy: Predictive factors and outcomes

Brandon Lau; Sanjeev Kumar; Tristan Yan; Juliet Burn; Catherine Kennedy; Jocelyn McLean; Michael Boyer; Brian McCaughan; Steven Kao

doi:10.1016/j.lungcan.2017.07.010

Pathological complete response in malignant pleural mesothelioma patients following induction chemotherapy: Predictive factors and outcomes

Lung Cancer. 2017 Sep:111:75-78. doi: 10.1016/j.lungcan.2017.07.010. Epub 2017 Jul 13.

Authors

Brandon Lau¹, Sanjeev Kumar², Tristan Yan³, Juliet Burn⁴, Catherine Kennedy⁵, Jocelyn McLean⁶, Michael Boyer⁷, Brian McCaughan⁸, Steven Kao⁹

Affiliations

¹ Department of Medical Oncology, Chris O'Brien Lifehouse, Sydney, Australia.
² Department of Medical Oncology, Chris O'Brien Lifehouse, Sydney, Australia; Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, UK.
³ Sydney Medical School, The University of Sydney, Sydney, Australia; Department of Cardiothoracic Surgery, Royal Prince Alfred Hospital, Sydney, Australia.
⁴ Douglas Hanly Moir Pathology, Sydney, Australia.
⁵ Sydney Medical School, The University of Sydney, Sydney, Australia; Strathfield Private Hospital, Sydney, Australia.
⁶ Asbestos Diseases Research Institute, Sydney, Australia.
⁷ Department of Medical Oncology, Chris O'Brien Lifehouse, Sydney, Australia; Sydney Medical School, The University of Sydney, Sydney, Australia.
⁸ Sydney Medical School, The University of Sydney, Sydney, Australia; Sydney Cardiothoracic Surgeons, Sydney, Australia.
⁹ Department of Medical Oncology, Chris O'Brien Lifehouse, Sydney, Australia; Sydney Medical School, The University of Sydney, Sydney, Australia; Asbestos Diseases Research Institute, Sydney, Australia. Electronic address: [email protected].

PMID: 28838403
DOI: 10.1016/j.lungcan.2017.07.010

Abstract

A small proportion of patients with malignant pleural mesothelioma (MPM) achieve pathological complete response (CR) following treatment with current practice induction chemotherapy. Our analysis of 58 patients with MPM treated with platinum-based chemotherapy showed 4 patients (7%) attained pathological CR at subsequent extrapleural pneumonectomy (EPP). Patient and tumour factors such as age, gender, smoking habit, histological subtype, and clinical stage were not found to be associated with pathological CR. Patients with pathological CR had longer disease-free survival (29.2 vs. 13.8 months; p=0.08) and overall survival (76.4 vs. 23.4 months; p=0.06) but this did not reach statistical significance. Our study suggests that patients who achieve pathological CR after chemotherapy may have improved survival in MPM.

Keywords: Extrapleural pneumonectomy; Malignant pleural mesothelioma; Pathological response; Prognosis; Survival.

MeSH terms

Adult
Aged
Aged, 80 and over
Antineoplastic Combined Chemotherapy Protocols / adverse effects
Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
Combined Modality Therapy
Female
Humans
Induction Chemotherapy
Kaplan-Meier Estimate
Lung Neoplasms / drug therapy*
Lung Neoplasms / mortality
Lung Neoplasms / pathology*
Male
Mesothelioma / drug therapy*
Mesothelioma / mortality
Mesothelioma / pathology*
Mesothelioma, Malignant
Middle Aged
Neoplasm Staging
Pleural Neoplasms / drug therapy*
Pleural Neoplasms / mortality
Pleural Neoplasms / pathology*
Prognosis
Retrospective Studies
Treatment Outcome