[Malignant mesothelioma--therapeutic response to various combinations of anthracyclines]

This report deals with results of chemotherapy with different antracycline combination in advanced malignant mesothelioma. Two patients were treated with CYVADIC combination including Adriamycin 40 mg/m2. There was no treatment response and both patients were evaluated as stable disease with median survival 5.5 months and median time to progression 4 months. Four patients were treated with Adriamycin 75 mg/m2 and Cisplatin 120 mg/m2. Two patients achieved a partial response with median survival 8 months and median time to progression 6.5 months. Combination treatment with Epirubicin 180 mg/m2 and Cisplatin 120 mg/m2 was applied to 5 patients, 4 being evaluable for activity. There was one partial response, median survival in this group was 5 months and median time to progression 3.5 months. The Adriamycin dose of 75 mg/m2 and the Epirubicin dose of 180 mg/m2, which were used in our patients are the highest escalated doses, not reported in literature data. Using the meta-analysis of both literature data and our study, which can be considered as a pilot study for dose escalation, there seems to be dose-effect relationship for antracyclin activity in malignant mesothelioma. The meta-analysis registers also slightly better treatment results (response rate 12.6% in 277 patients) with antracyclin containing regimens as compared to combination chemotherapy which does not include antracyclines (response rate 10.3% in 175 patients).