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Characteristics and long‐term outcomes of advanced pleural mesothelioma in Latin America (MeSO‐CLICaP)

BACKGROUND: Malignant pleural mesothelioma (MPM) is an aggressive tumor, associated with poor prognosis. There is a lack of information about the clinical and pathological features related with survival in the Latin American population. METHODS: The MeSO‐CLICaP registry identified 302 patients with...

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Detalles Bibliográficos
Autores principales: Rojas, Leonardo, Cardona, Andrés F., Trejo‐Rosales, Rogelio, Zatarain‐Barrón, Zyanya Lucia, Ramírez‐Tirado, Laura‐Alejandra, Ruiz‐Patiño, Alejandro, Campos Gómez, Saúl, Corrales, Luis, Oblitas, George, Bacon, Ludwing, Martín, Claudio, de Lima, Vladmir C. Cordeiro, Freitas, Helano C., Mas, Luis, Vargas, Carlos, Carranza, Hernán, Otero, Jorge, Pérez, María Angelina, González, Lisde, Chirinos, Luis, Granados, Sara T., Rodriguez, July, Báez, Renata, Remolina Bonilla, Yuly‐Andrea, Núñez Cerrillo, Gustavo, Archila, Pilar, Cuello, Mauricio, Karachaliou, Niki, Rosell, Rafael, Arrieta, Oscar
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley & Sons Australia, Ltd 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6397921/
https://www.ncbi.nlm.nih.gov/pubmed/30706690
http://dx.doi.org/10.1111/1759-7714.12967
Descripción
Sumario:BACKGROUND: Malignant pleural mesothelioma (MPM) is an aggressive tumor, associated with poor prognosis. There is a lack of information about the clinical and pathological features related with survival in the Latin American population. METHODS: The MeSO‐CLICaP registry identified 302 patients with advanced MPM diagnosed and treated between January 2008 and March 2016. The Cox model was applied to determine the variables associated with survival. A random forest tree model was built to predict the response to first‐line chemotherapy among Latin American patients. RESULTS: The median age was 61.1 years (SD 10.6 years), 191 (63.2%) were men, 65.9% were ever smokers, and 38.7% had previous exposure to asbestos. A total of 237 (78.5%) had epithelioid tumors, and 188 (62.3%) and 114 (37.7%) cases had stage III or IV MPM, respectively. A total of 49 patients (16.2%) underwent pleurectomy, 57 (18.9%) received radiotherapy, and 279 patients received first‐line platinum‐based chemotherapy. The overall response rate to first‐line chemotherapy was 40.4%, progression‐free survival to first‐line treatment was 5.7 months (95% CI 4.9–6.5), and 63 (20.8%) patients had pemetrexed maintenance. The median overall survival was 16.8 months (95% CI 13.0–20.5), and multivariate analysis found that stage (P = 0.013), and pleurodesis (P = 0.048), were independent prognostic factors for first‐line overall survival. The model to predict response to first‐line chemotherapy obtained a 0.98 area under the curve, a sensitivity of 93%, and a specificity of 95% for detecting responders and non‐responders. CONCLUSION: This study identifies factors associated with clinical benefit from chemotherapy among advanced MPM Latin American patients, emphasizing the impact of histology and the clinical benefit of chemotherapy on outcomes.