Efficacy of cisplatin-based intraperitoneal chemotherapy as treatment of malignant peritoneal mesothelioma

  • Maurie Markman
  • David Kelsen
Original Papers Clinical Oncology


In an effort to examine the potential clinical utility of intraperitoneal (i.p.) therapy in the management of patients with malignant peritoneal mesothelioma, 19 individuals with this disease were treated with a cisplatinbased i.p. treatment regimen. All but 1 patient also received i.p. mitomycin. The treatment was generally well tolerated, although a maximum of only four or five courses of cisplatin (100 mg/m2 every 28 days) and mitomycin (5–10 mg/treatment given 7 days after each i.p. cisplatin administration) could be administered, the treatment principally being stopped because of disease progression or catheter failure. Of 15 patients with malignant ascites, 7 (47%) experienced control of fluid reaccumulation ranging from 2 months to 73+ months (median 8 months). While the median survival for the 19 patients was only 9 months, 4 (21%) patients survived for more than 3 years from the initiation of therapy, and 2 patients are currently alive and clinically disease-free more than 5 years from the start of the i.p. treatment program. We conclude that a subset of patients with peritoneal mesothelioma, principally those with small-volume residual disease following surgical tumor debulking, can benefit from a cisplatin-based i.p. treatment strategy with control of ascites and prolonged disease-free survival.

Key words

Peritoneal mesothelioma Intraperitoneal chemotherapy Cisplatin Mitomycin 


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  1. Antman KH, Pomfret EA, Aisner J, MacIntyre J, Osteen RT, Greenberger JS (1983) Peritoneal mesothelioma: natural history and response to chemotherapy. J Clin Oncol 1:386–391Google Scholar
  2. Antman KH, Klegar KL, Pomfret EA, Osteen RT, Amato DA, Larson DA, Corson JM (1985) Early peritoneal mesothelioma. A treatable malignancy. Lancet 2:977–980Google Scholar
  3. Bajorin D, Kelsen D, Mintzer DM (1987) Phase II trial of mitomycin in malignant mesothelioma. Cancer Treat Rep 71:857–858Google Scholar
  4. Kirmani S, Cleary SM, Mowjy J (1988) Intracavitary cisplatin for malignant mesothelioma: an update (abstract). Proc. Am Soc. Clin Oncol 7:273Google Scholar
  5. Lederman GS, Recht A, Herman T (1987) Long-term survival in peritoneal mesothelioma: the role of radiotherapy and combined modality treatment. Cancer 59:1882–1886Google Scholar
  6. Los G, Mutsaers PHA, Vijgh WJF van der, Baldew GS, Graaf PW de, McVie JG (1989) Direct diffusion ofcis-diamminedichloroplatinum(II) in intraperitoneal rat tumors after intraperitoneal chemotherapy: a comparison with systemic chemotherapy. Cancer Res 49:3380–3384Google Scholar
  7. Markman M, Kelsen D (1989) Intraperitoneal cisplatin and mitomycin as treatment of malignant peritoneal mesothelioma. Reg Cancer Treat 2:49–53Google Scholar
  8. Markman M, Cleary S, Pfeifle CE, Howell SB (1986) Cisplatin administered by the intracavitary route as treatment for malignant mesothelioma. Cancer 58:18–21Google Scholar
  9. Markman M, Reichman B, Hakes T, Jones W, Lewis JL Jr, Rubin S, Almadrones L, Hoskins W (1991) Responses to second-line cisplatin-based intraperitoneal therapy in ovarian cancer: influence of a prior response to intravenous cisplatin. J Clin Oncol 9:1801–1805Google Scholar
  10. Miller Ab, Hoogstraten S, Staquet M (1981) Reporting results of cancer treatment Cancer 47:207–214Google Scholar
  11. Mintzer DM, Kelsen D, Frimmer D (1985) Phase II trial of high-dose cisplatin in patients with malignant mesothelioma. Cancer Treat Rep 69:711–712Google Scholar
  12. Ozols RF, Young RC (1987) Ovarian cancer. Curr Probl Cancer 11:57–122Google Scholar
  13. Ozols RF, Locker GY, Doroshow JH, Grotzinger, KR, Myers CE, Young RC (1979) Pharmacokinetics of Adriamycin and tissue penetration in murine ovarian cancer. Cancer Res 39:3209–3214Google Scholar
  14. Pfeifle CE, Howell SB, Markman M (1985) Intracavitary cisplatin chemotherapy for mesothelioma. Cancer Treat Rep 69:205–207Google Scholar

Copyright information

© Springer-Verlag 1992

Authors and Affiliations

  • Maurie Markman
    • 1
    • 2
  • David Kelsen
    • 1
    • 2
  1. 1.The Breast/Gynecology Oncology ServiceMemorial Sloan-Kettering Cancer CenterNew YorkUSA
  2. 2.Gastrointestinal Oncology Service, Division of Solid Tumor Oncology, Department of MedicineMemorial Sloan-Kettering Cancer CenterNew YorkUSA

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