GOOD SYMPTOM RELIEF WITH PALLIATIVE MVP (MITOMYCIN-C, VINBLASTINE ANDCISPLATIN) CHEMOTHERAPY IN MALIGNANT MESOTHELIOMA

Purpose: To evaluate the therapeutic impact of a simple com bination c hemotherapy regimen on symptoms related to malignant mesothelioma. Mat erials and Methods: Between October 1986 and June 1997, 39 patients wi th advanced inoperable malignant mesothelioma were treated with pallia tive MVP (mitomycin-C 8 mg/m(2) q. six weeks, vinblastine 6 mg/m(2) q. three weeks and cisplatin 50 mg/m(2) q. three weeks) chemotherapy and assessed for objective response and relief of symptoms. Results. Eigh t of 39 patients (20%) achieved an objective partial response with a m edian duration of nine months: only five patients had progression of d isease during chemotherapy. Twenty-Four of 39 (62%) had an overall imp rovement in their symptomology with particularly good responses for pa in (79%). These benefits were independent of performance status. Resol ution of symptoms was achieved in all responding patients within two t reatment cycles. There was no statistically significant difference in duration and incidence of symptom response in those patients achieving radiological PR compared with those with no change and more than 60% of patients with radiological no change obtained useful symptom contro l. The treatment was well tolerated with only four patients developing grade 3 leucopenia and three with grade 3 nausea. Conclusions. MVP is a well tolerated regimen and its use in malignant mesothelioma provid es useful symptomatic benefit. These results should be the basis for f urther trials of MVP in the management of mesothelioma with symptom co ntrol as a principal endpoint.