From: HubMed - mesothelioma <rssfwd@rssfwd.com>
To: shell8377@yahoo.com
Sent: Thursday, February 21, 2008 5:06:53 PM
Subject: Gemcitabine and vinorelbine in pemetrexed-pretreated patients with malignant pleural mesothelioma.
[1]Cancer. 2008 Feb 19;
Zucali PA, Ceresoli GL, Garassino I, De Vincenzo F, Cavina R, Campagnoli E, Cappuzzo F, Salamina S, Soto Parra HJ, Santoro A
BACKGROUND: Pemetrexed-cisplatin chemotherapy is the standard of care in the first-line treatment of unresectable malignant pleural mesothelioma (MPM). Second-line cytotoxic therapy is considered for a growing group of patients, but the optimal treatment has not been defined to date. Gemcitabine and vinorelbine have shown activity in the first-line setting. The objective of this study was to evaluate the activity and toxicity of the gemcitabine-vinorelbine combination in pemetrexed-pretreated patients with MPM. METHODS: From January 2004 to September 2006, 30 consecutive patients who were pretreated with pemetrexed with or without a platinum-derivative were enrolled. Gemcitabine 1000 mg/m(2) and vinorelbine 25 mg/m(2) were administered intravenously on Days 1 and 8 every 3 weeks. Treatment was repeated for a maximum of 6 cycles or until progression or unacceptable toxicity. RESULTS: A partial response was observed in 3 patients (10%; 95% confidence interval [CI], 2.1-26.5%), and 10 patients (33.3%; 95% CI, 17.3-52.8%) had stable disease after treatment. Overall, 13 patients (43.3%; 95% CI, 25.5-62.6%) achieved disease control. The median time to progression was 2.8 months (range, 0.6-12.1 months), and the median survival was 10.9 months (range, 0.8-25.3 months). Hematologic toxicity was acceptable, with grade 3 or 4 neutropenia occurring in 11% of patients and thrombocytopenia occurring in 4% of patients; no case of febrile neutropenia was observed. Nonhematologic toxicity generally was mild. CONCLUSIONS: The gemcitabine and vinorelbine combination was moderately active and had an acceptable toxicity profile in pemetrexed-pretreated patients with MPM. The role of second-line treatment in MPM needs to be evaluated in prospective trials in large series of patients who are stratified according to previous treatment and prognostic factors. Cancer 2008. (c) 2008 American Cancer Society.
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Source: http://www.hubmed.org/display.cgi?uids=18286536
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Unlike lung cancer, there is no association between mesothelioma and smoking Malignancies involving mesothelial cells in these spread cavities are known as malignant mesothelioma, which may be localized or diffuse. Mesothelioma is the word used to describe a cancerous tumor that involves the mesothelial cells of an organ, often the lungs, heart, or abdominal organs.
Mesothelioma diagnosis in this disease, malignant cells develop in the mesothelium, a protective lining that covers transcendently of the spread's internal organs. Greatest malignant mesothelioma set up complex karyotypes, with extensive aneuploidy and rearrangement of tons chromosomes.
Symptoms of mesothelioma may not appear until 20 to 50 years after exposure to asbestos. Mesothelioma diagnosis is often difficult, because the symptoms are similar to those of a number of other conditions. A history of exposure to asbestos may increase clinical suspicion for mesothelioma. A physical examination is performed, followed by chest X-ray and often lung function tests. The X-ray may reveal pleural thickening commonly seen after asbestos exposure if mesothelioma diagnosis is done.
If the cancer has length beyond the mesothelium to other parts of the size, symptoms may include pain, trouble swallowing, or swelling of the neck or engage.
Symptoms of peritoneal mesothelioma include weight loss and cachexia, abdominal swelling and suffering due to ascites (a buildup of fluid in the abdominal cavity). Exposure to airborne asbestos particles increases one's risk of developing malignant mesothelioma.
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