Transarterial Chemoperfusion Treatment of Unresectable Pleural Mesothelioma – Interim Results of a Phase 2 Prospective Study

Presented During:

Sun, 6/14/2020: 12:05 PM  - 12:14 PM 
Webinar  
Room: Webinar  

Final ID:

Authors:

B Kis1, M Pereira1, J Logeman2, Z Makovich2, G El-Haddad3, J Choi4, J Fontaine1, B Creelan1, T Tanvetyanon1

Institutions:

1Moffitt Cancer Center, Tampa, FL, 2Morsani College of Medicine, University of South Florida, Tampa, FL, 3N/A, Tampa, FL, 4H. Lee Moffitt Cancer Center, Tampa, FL

First Author:

Bela Kis, MD, PhD  
Moffitt Cancer Center
Tampa, FL

Co-Author(s):

Malesa Pereira  
Moffitt Cancer Center
Tampa, FL
JerryRay Logeman  
Morsani College of Medicine, University of South Florida
Tampa, FL
Zachary Makovich  
Morsani College of Medicine, University of South Florida
Tampa, FL
Ghassan E. El-Haddad, MD  
N/A
Tampa, FL
Junsung Choi, MD  
H. Lee Moffitt Cancer Center
Tampa, FL
Jacques Fontaine  
Moffitt Cancer Center
Tampa, FL
Ben Creelan  
Moffitt Cancer Center
Tampa, FL
Tawee Tanvetyanon  
Moffitt Cancer Center
Tampa, FL

Presenting Author:

Bela Kis, MD, PhD  
Moffitt Cancer Center
Tampa, FL

Purpose:

Transarterial chemoperfusion treatment selectively delivers relatively high concentration of chemotherapy to the targeted tissue's arterial bed maximizing antitumoral effect and minimizing systemic side effects. Advanced malignant pleural mesothelioma (MPM) carries a poor prognosis. The current prospective study (ClinicalTrials.gov Identifier: NCT02611037) is investigating the disease control rate, overall survival and adverse events of TAC treatment in patients with relapsed unresectable MPM.

Materials:

27 patients, 4 female and 23 males (age 70.8±6.8 years), with MPM were enrolled between 3/2016-6/2019. Patients had transarterial chemoperfusion treatment in every 4 weeks with cisplatin (35 mg/m2), methotrexate (100 mg/m2) and gemcitabine (1000 mg/m2) via the ipsilateral internal mammary artery and/or descending thoracic aorta. All patients had received and progressed on prior chemotherapy. 4 patients also had radiation therapy and 3 patients had pleurectomy. The number of prior treatments was 1.93±1.3 (range: 1-6). Response rate was evaluated by modified RECIST for mesothelioma.

Results:

At the data cutoff date (September 15, 2019) 18 of the 27 patients had died. The median follow-up time was 6 months. The disease control rate was 70.3% (1 PR, 18 SD, 8 PD). Median progression free survival from the enrollment was 4.6 months (95% CI 1.1-8). Median OS was 8.5 months (95% CI 3.5-13.6). A total of 145 TAC treatments were performed. The median number of treatments was 4/patient (range 1-27). There was no treatment related mortality. Major complication rate was 1.4%. There were 133 events of minor complications; the most common was 56 events of chest pain during transarterial chemoperfusion into the internal mammary artery, followed by 24 events of nausea.

Conclusions:

Transarterial chemoperfusion treatment with cisplatin, methotrexate and gemcitabine in every 4 weeks is feasible and safe. The treatment has promising disease control rate in this group of heavily pretreated patients with relapsed MPM.

Abstract Categories:

Interventional Oncology: Other

Keywords:

Chemo-infusion
Mesothelioma