Abstract
Ten patients with histologically documented peritoneal mesothelioma were treated with intraperitoneal cisplatin 200 mg/m2, sodium thiosulfate rescue and etoposide 65–290 mg/m2 every 4 weeks for a maximum of six cycles. All had epithelial or mixed epithelial-fibrous histology. Toxicity was tolerable, with 50% sustaining grade 3 or 4 granulocytopenia. There was one episode of neutropenic fever. Grade 2 peripheral neuropathy occurred in one patient, grade 1 in five patients. Complete remission occurred in one of five patients with measurable disease. Median survival for patients whose tumors were surgically debulked to <2 cm residua prior to treatment was 22 months, while it was 5 months for those with measurable, surgically inaccessible disease (P=0.0731 by Cox regression proportional hazard model). These data suggest that patients who present with resectable disease may benefit from an aggressive adjuvant approach. This possibility warrants prospective testing in a randomized clinical trial.
Similar content being viewed by others
References
Antman KH, Pomfiet E, Aisner J, et al (1983) Peritoneal mesothelioma: natural history and response to chemotherapy. J Clin Oncol 1: 386
Antman K, Osteen R, Klegar K, et al (1985) Early peritoneal mesothelioma: treatable malignancy. Lancet 1: 977–981
Decker H-JH, Li FP, Bixenman HA, Sandberg AA (1990) Chromosome 3 and 12p rearranged in a well-differentiated peritoneal mesothelioma. Cancer Genet Cytogenet 46: 135–137
Delgado G, Oram dH, Petrilli EG (1984) Stage III epithelial ovarian cancer. The role of maximal surgical reduction. Gynecol Oncol 18: 293
Gibas Z, Li FP, Antman KH, Bernal S, Stahel R, Sandberg AA (1986) Chromosomal changes in malignant mesothelioma. Cancer Genet Cytogenet 20: 191–201
Howell SB, Taetle R (1980) Effect of sodium thiosulfate on cisdichloro-diammine-platinum(II) toxicity and antitumor activity in L1210 leukemia. Cancer Treat Rep 64: 611–616
Howell SB, Pfeifle CL, Wung WE, et al (1982) Intraperitoneal cisplatin with systemic thiosulfate protection. Ann Intern Med 97: 845–851
Kirmani S, Cleary SM, Mowry J, Howell SB (1988) Intracavitary cisplatin for malignant mesothelioma: an update. Proc Am Soc Clin Oncol 7: A1057
LaCreta FP, Comis RL, Hogan M, et al (1989) Phase I/pharmacokinetic study of intraperitoneal (IP) etoposide and high dose cisplatin. Proc Am Soc Clin Oncol 8: 284
Lederman GS, Recht A, Herman T, et al (1987) Long-term survival in peritoneal mesothelioma. The role of radiotherapy and combined modality treatment. Cancer 59: 1882–1886
Legha SS, Muggia FM (1977) Therapeutic approaches in malignant mesothelioma. Cancer Treat Rev 4: 13–23
Miller AB, Hoogstraten B, Staquet M, Winkler A (1981) Reporting results of cancer treatment. Cancer 47: 207–214
Moertel C (1972) Peritoneal mesothelioma. Gastroenterology 63: 346
O'Dwyer PT, LaCreta FP, Dougherty JP, et al (1991) Phase I pharmacokinetic study of intraperitoneal etoposide. Cancer Res 51 (8): 2041–2046
Popesan NC, Chahinian AP, DiPaolo JA (1988) Nonrandom chromosome alteration in human malignant mesothelioma. Cancer Res 48: 142–147
Rogoff E, Hilaris B, Huvos A (1973) Long-term survival in patients with malignant peritoneal mesothelioma treated with irradiation. Cancer 32: 656–664
Rose RG, Palmer JD, Longheed MN (1955) Treatment of peritoneal mesothelioma with radioactive colloidal gold. Cancer 8: 478–481
Tiainen M, Tammilehto L, Rautonen J, Tuomi T, Mattson K, Kuutila S (1989) Chromosomal abnormalities and their correlations with asbestos exposure and survival in patients with mesothelioma. Br J Cancer 60: 618–626
Van Gelder T, Hoogsteden H, Versnel M (1989) Malignant peritoneal mesothelioma: a series of 19 cases. Digestion 43: 222–227
Zimm S, Cleary S, Lucas W, et al (1987) Phase I/pharmacokinetic study of intraperitoneal cisplatin and etoposide. Cancer Res 6: 1712–1716
Author information
Authors and Affiliations
Additional information
This work was supported in part by Grant CA-06927 from NCI/NIH
Rights and permissions
About this article
Cite this article
Langer, C.J., Rosenblum, N., Hogan, M. et al. Intraperitoneal cisplatin and etoposide in peritoneal mesothelioma: favorable outcome with a multimodality approach. Cancer Chemother. Pharmacol. 32, 204–208 (1993). https://doi.org/10.1007/BF00685836
Issue Date:
DOI: https://doi.org/10.1007/BF00685836