This preprint is under consideration at BMC Cancer. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research Article
Efficacy of a second-line treatment and prognostic factors in patients with advanced malignant peritoneal mesothelioma: a retrospective study
rui Kitadai
National Cancer Center Hospital, Japan
Corresponding Author
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background
A standard treatment for malignant peritoneal mesothelioma has not been established, and systemic chemotherapy is administered according to malignant pleural mesothelioma. We previously reported the efficacy of cisplatin plus pemetrexed as first-line chemotherapy; however, the efficacy of second-line chemotherapy remains unknown.
Methods
We retrospectively evaluated patients with malignant peritoneal mesothelioma who started first-line systemic chemotherapy with platinum plus pemetrexed between March 2007 and February 2019 at the National Cancer Center Hospital. Patients who received second-line chemotherapy after failure of platinum plus pemetrexed were identified. We evaluated the efficacy of first- and second-line chemotherapy, and explored the prognostic factors. Survival outcomes were determined using Kaplan-Meier estimation, and between-group differences were assessed using the log-rank test. Univariate and multivariate analyses were performed using Cox proportional hazard models.
Results
A total of 54 and 26 patients received platinum plus pemetrexed as first- and second-line chemotherapy, respectively (gemcitabine in 12 patients; taxane, 6; nivolumab, 3; and others, 5). In all patients, the median overall survival and progression-free survival after first-line chemotherapy were 16.6 and 7.3 months, respectively. Among patients who received second-line chemotherapy, the median overall survival, progression-free survival, and second-line overall survival were 16.9, 3.2, and 9.9 months, respectively. Patients who received 6 or more cycles of platinum plus pemetrexed as first-line chemotherapy had longer overall survival after second-line chemotherapy than those who did not (hazard ratio, 0.23; 95% confidence interval: 0.06–0.82; p = 0.02).
Conclusions
Second-line chemotherapy can be an option for refractory malignant peritoneal mesothelioma, especially for patients who have completed 6 cycles of platinum plus pemetrexed as a first-line chemotherapy.
Keywords
Malignant peritoneal mesothelioma, second-line chemotherapy, efficacy, prognosis
Figure 1
Figure 2
Figure 3
This is a list of supplementary files associated with this preprint. Click to download.
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
Version 1
Posted 12 Jan, 2021
No community comments so far
Review #3 received
Received 10 Jan, 2021
Review #1 received
Received 10 Jan, 2021
Review #4 received
Received 10 Jan, 2021
Review #6 received
Received 10 Jan, 2021
Review #2 received
Received 10 Jan, 2021
Review #5 received
Received 10 Jan, 2021
Reviewer #1 agreed
On 09 Jan, 2021
Reviewer #6 agreed
On 09 Jan, 2021
Reviewer #2 agreed
On 09 Jan, 2021
Reviewer #4 agreed
On 09 Jan, 2021
Reviewer #7 agreed
On 09 Jan, 2021
Reviewer #9 agreed
On 09 Jan, 2021
Reviewer #3 agreed
On 09 Jan, 2021
Reviewer #5 agreed
On 09 Jan, 2021
Reviewer #8 agreed
On 09 Jan, 2021
Reviewers invited
Invitations sent on 09 Jan, 2021
Editor assigned
On 08 Jan, 2021
Editor invited
On 08 Jan, 2021
Submission checks complete
On 08 Jan, 2021
First submitted
On 01 Jan, 2021
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Learn more about our company.
This preprint is under consideration at BMC Cancer. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research Article
Efficacy of a second-line treatment and prognostic factors in patients with advanced malignant peritoneal mesothelioma: a retrospective study
rui Kitadai
National Cancer Center Hospital, Japan
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
Version 1
Posted 12 Jan, 2021
No community comments so far
Review #3 received
Received 10 Jan, 2021
Review #1 received
Received 10 Jan, 2021
Review #4 received
Received 10 Jan, 2021
Review #6 received
Received 10 Jan, 2021
Review #2 received
Received 10 Jan, 2021
Review #5 received
Received 10 Jan, 2021
Reviewer #1 agreed
On 09 Jan, 2021
Reviewer #6 agreed
On 09 Jan, 2021
Reviewer #2 agreed
On 09 Jan, 2021
Reviewer #4 agreed
On 09 Jan, 2021
Reviewer #7 agreed
On 09 Jan, 2021
Reviewer #9 agreed
On 09 Jan, 2021
Reviewer #3 agreed
On 09 Jan, 2021
Reviewer #5 agreed
On 09 Jan, 2021
Reviewer #8 agreed
On 09 Jan, 2021
Reviewers invited
Invitations sent on 09 Jan, 2021
Editor assigned
On 08 Jan, 2021
Editor invited
On 08 Jan, 2021
Submission checks complete
On 08 Jan, 2021
First submitted
On 01 Jan, 2021
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background
A standard treatment for malignant peritoneal mesothelioma has not been established, and systemic chemotherapy is administered according to malignant pleural mesothelioma. We previously reported the efficacy of cisplatin plus pemetrexed as first-line chemotherapy; however, the efficacy of second-line chemotherapy remains unknown.
Methods
We retrospectively evaluated patients with malignant peritoneal mesothelioma who started first-line systemic chemotherapy with platinum plus pemetrexed between March 2007 and February 2019 at the National Cancer Center Hospital. Patients who received second-line chemotherapy after failure of platinum plus pemetrexed were identified. We evaluated the efficacy of first- and second-line chemotherapy, and explored the prognostic factors. Survival outcomes were determined using Kaplan-Meier estimation, and between-group differences were assessed using the log-rank test. Univariate and multivariate analyses were performed using Cox proportional hazard models.
Results
A total of 54 and 26 patients received platinum plus pemetrexed as first- and second-line chemotherapy, respectively (gemcitabine in 12 patients; taxane, 6; nivolumab, 3; and others, 5). In all patients, the median overall survival and progression-free survival after first-line chemotherapy were 16.6 and 7.3 months, respectively. Among patients who received second-line chemotherapy, the median overall survival, progression-free survival, and second-line overall survival were 16.9, 3.2, and 9.9 months, respectively. Patients who received 6 or more cycles of platinum plus pemetrexed as first-line chemotherapy had longer overall survival after second-line chemotherapy than those who did not (hazard ratio, 0.23; 95% confidence interval: 0.06–0.82; p = 0.02).
Conclusions
Second-line chemotherapy can be an option for refractory malignant peritoneal mesothelioma, especially for patients who have completed 6 cycles of platinum plus pemetrexed as a first-line chemotherapy.
Figure 1
Figure 2
Figure 3