Abstract | OBJECTIVES: METHODS: A total of 12 patients (75% International Mesothelioma Interest Group stage III-IV) were treated with 4 dose levels of intracavitary cisplatin- fibrin (11-44 mg/m2 body surface area) in a dose-escalating design. Cisplatin- fibrin was sprayed on the resected surfaces after pleurectomy/decortication. Blood and tissue samples were taken to assess toxicity and pharmacokinetics. Patients were regularly followed up. RESULTS: No dose-limiting toxicity was observed. Major morbidity occurred in 4 patients (33%). The 30-day and 90-day mortality were both 0%. Of 80 adverse events, 9 were classified serious, but none of these were related to study treatment. Local cisplatin concentration in the chest wall tissue was high at all dose levels (median, 46.3 μg/g [12-133 μg/g]). In serum, median cisplatin area under the concentration time curve values were always below renal toxicity levels. The median overall survival with 95% confidence interval was 21 months (10-31 months). In 1 patient with epithelioid malignant pleural mesothelioma (International Mesothelioma Interest Group stage I), there was no sign of relapse 48 months after treatment (44 mg/m2 body surface area). CONCLUSIONS: The administration of intracavitary cisplatin- fibrin is safe with favorable pharmacokinetics. Although most patients had advanced disease, long-term outcomes are comparable to other multimodal concepts. A confirmation phase II trial is ongoing.
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Authors | Isabelle Opitz, Olivia Lauk, Mayura Meerang, Alexander Jetter, Beat Aeschlimann, Burkhardt Seifert, Detlef Günther, Rolf A Stahel, Walter Weder |
Journal | The Journal of thoracic and cardiovascular surgery
(J Thorac Cardiovasc Surg)
Vol. 159
Issue 1
Pg. 330-340.e4
(Jan 2020)
ISSN: 1097-685X [Electronic] United States |
PMID | 31590949
(Publication Type: Journal Article)
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Copyright | Copyright © 2019 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved. |