Cisplatin, mitomycin, and interferon-alpha 2a combination chemoimmunotherapy in the treatment of diffuse malignant pleural mesothelioma

Study objective: To investigate the therapeutic activity and toxicity of co mbination chemoimmunotherapy with cisplatin, mitomycin, and interferon (IFN )-alpha 2a, by comparing the responses in a group of patients with diffuse malignant pleural mesothelioma (DMPM) to the responses in a control group o f DMPM patients given supportive care alone. Design: Patients with histopathologically confirmed DMPM were evaluated for treatment with chemoimmunotherapy, Setting: After the initial evaluation, all patients received either chemoim munotherapy or supportive care from the Osmangazi University Medical Facult y, Department of Chest Diseases. Patients: Forty-three patients with DMPM received chemoimmunotherapy until the end of the survey; 19 patients were given supportive therapy alone afte r refusing chemoimmunotherapy, Interventions: Drugs were administered accor ding to the following schedule: IV cisplatin, 30 mg/m(2) qd on days 1 and 2 ; IV mitomycin, 8 mg/m(2) on day 1; and subcutaneous IFN-alpha 2a, 4.5 mill ion IU twice weekly. The courses were repeated every 4 weeks. Results: Overall, 232 chemoimmunotherapy cycles were administered. A total of 10 objective responses (ORs) in 43 patients (23%) were assessed, includi ng 2 complete responses (5%), 4 partial responses, and 4 regressions. Seven teen patients had stable disease, and 16 patients had progression. The medi an survival time was 11.5 months for the 43 patients who received chemoimmu notherapy and 7.0 months for the 19 patients who received supportive therap y alone. The difference in survival times between the chemoimmunotherapy an d supportive therapy groups was not significant. However, the median surviv al time for the patients who had OR was 21.3 months, which is significantly longer than that of the patients who received supportive care alone and th at of patients with progressive disease (6 months). The toxicities associat ed with the treatment schedule of this study were, for the most part, toler able. Conclusions: The drug combination used in this study is moderately effectiv e and well tolerated in patients with DMPM, especially in those who respond ed to the treatment.