The palliative benefits of MVP (mitomycin C, vinblastine and cisplatin) chemotherapy in patients with malignant mesothelioma

• Published in: Annals of oncology Vol. 15; no. 9; pp. 1406 - 1412
• Main Authors: Andreopoulou, E., Ross, P. J., O'Brien, M. E. R., Ford, H. E. R., Priest, K., Eisen, T., Norton, A., Ashley, S., Smith, I. E.
• Format: Journal Article
• Language: English
• Published: Oxford Oxford University Press 01-09-2004
• Subjects: Adult; Aged; Antibiotics, Antineoplastic - adverse effects; Antibiotics, Antineoplastic - therapeutic use; Antineoplastic agents; Antineoplastic Combined Chemotherapy Protocols - adverse effects; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Biological and medical sciences; Cisplatin - administration & dosage; Cisplatin - adverse effects; Female; Humans; Male; Medical sciences; mesothelioma; Mesothelioma - drug therapy; Mesothelioma - mortality; Middle Aged; Mitomycin - administration & dosage; Mitomycin - adverse effects; Multivariate Analysis; MVP; palliative chemotherapy; Pharmacology. Drug treatments; Pleural Neoplasms - drug therapy; Pleural Neoplasms - mortality; Prospective Studies; survival; Survival Analysis; Survival Rate; symptoms; Treatment Outcome; Tumors; Vinblastine - administration & dosage; Vinblastine - adverse effects; Weight Loss - drug effects; Antineoplastic agent; Human; Mitomycin; Vinblastine; palliative chemotherapy; Malignant tumor; Survival; Cisplatin; MVP. survival; symptoms; Symptomatology; Alkylating agent; Alkaloid; Chemotherapy; Malignant mesothelioma; Treatment; mesothelioma; Antimitotic; Platinum II Complexes
• ISSN: 0923-7534; 1569-8041
• DOI: 10.1093/annonc/mdh356

Background: With the rising incidence of malignant mesothelioma (MM), it is important to optimise treatment to control symptoms, maintain quality of life and, if possible, prolong life. We have analysed prospectively collected data to evaluate a frequently used palliative chemotherapy regimen. Patients and methods: Between October 1986 and May 2002 all patients with inoperable pleural mesothelioma were considered for treatment with MVP (mitomycin C 8 mg/m2 every 6 weeks, vinblastine 6 mg/m2 every 3 weeks and cisplatin 50 mg/m2 every 3 weeks) chemotherapy. Symptoms were assessed by physician assessment at baseline and after each cycle of chemotherapy. Results: One hundred and fifty patients were treated with MVP for mesothelioma. Forty-three per cent had a performance status (PS) 2 or worse. The response rate was 15.3%, with 68.6% having stable disease. Sixty-nine per cent reported an improvement in symptoms; in particular there were good responses for pain (71%), cough (62%) and dyspnoea (50%). The most common grade 3/4 toxicity was neutropenia (22%). Median overall survival was 7 months, with 1-year survival 31% and 2-year survival 11%. Median survival for patients with PS 0/1 was 10 months, and was 6 months for patients with PS 2/3. Poor prognostic factors in univariate analysis included poor PS, weight loss, mixed or sarcomatoid histology, low haemoglobin and high white blood cell count. Excluding pathological subtype, the prognostic significance of poor PS and weight loss were retained in multivariate analysis. Conclusions: Palliation of symptoms in MM is achievable with current cisplatin-based treatments.