Immediate Versus Deferred Systemic Therapy in Patients With Mesothelioma.

Schmid, Sabine; Zhan, Luna; Garcia, Miguel; Dietrich, Kristen; Khan, Khaleeq; Chowdhury, Maisha; Herman, Michael; Patel, Devalben; Zaeimi, Fatemeh; Leighl, Natasha B; Sacher, Adrian; Feld, Ronald; Shepherd, Frances A; Donahoe, Laura; de Perrot, Marc; Cho, B C John; Liu, Geoffrey; Bradbury, Penelope A (2024). Immediate Versus Deferred Systemic Therapy in Patients With Mesothelioma. (In Press). Clinical lung cancer Elsevier 10.1016/j.cllc.2024.04.011

[img] Text
1-s2.0-S1525730424000664-main.pdf - Published Version
Restricted to registered users only
Available under License Publisher holds Copyright.

Download (2MB)

BACKGROUND

The 2018 ASCO pleural mesothelioma (PM) treatment guideline states that "a trial of expectant observation may be offered" in patients with asymptomatic inoperable epithelioid mesothelioma with low disease burden. The aim of our analysis was to evaluate clinical characteristics and outcomes in PM-patients managed with initial observation and deferred treatment initiation.

METHODS

We retrospectively collected clinicodemograhic and outcome data of patients with inoperable PM. Patients were assigned to 2 treatment decision groups: decision to start immediate systemic treatment (Immediate Treatment Group) versus observation and deferring treatment (Deferred Treatment group).

RESULTS

Of 222 patients with advanced PM, systemic treatment was started immediately in the majority of patients (189, 85%; immediate group); treatment was deferred in 33 (15%) patients (deferred group); systemic therapy was chemotherapy-based in 91% and 79% respectively. Patients in the deferred group were older (70 vs 67 years, p = .05), less likely to have stage IV disease (28% vs. 51%, p = .08) and more often had epithelioid histology (90% vs. 70%, p = .03). Nineteen patients (58%) in the deferred group eventually received treatment. With a median follow-up time of 10.9 months median overall survival (OS) in the entire cohort was 12.4 months and was significantly longer in the deferred group (20.6 months vs. 11.5 months, p = .02). No difference in median progression-free survival (PFS) in first-line treatment between groups was seen (5.4 and 5.3 months).

CONCLUSION

This real-world analysis suggests that deferral of systemic therapy and close observation may not impact OS or physician-assessed PFS in selected PM-patients.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Medical Oncology

UniBE Contributor:

Schmid, Sabine

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1525-7304

Publisher:

Elsevier

Language:

English

Submitter:

Pubmed Import

Date Deposited:

03 Jun 2024 15:38

Last Modified:

04 Jun 2024 15:28

Publisher DOI:

10.1016/j.cllc.2024.04.011

PubMed ID:

38825405

Uncontrolled Keywords:

ASCO Guideline Expectant observation Mesothelioma Systemic treatment

BORIS DOI:

10.48350/197465

URI:

https://boris.unibe.ch/id/eprint/197465

Actions (login required)

Edit item Edit item
Provide Feedback