Raltitrexed plus Cisplatin for Malignant Pleural Mesothelioma: A Systematic Review_Chinese Journal of Evidence-Based Medicine

Authors：

YANG Shukun ¹ , TIAN Jinhui ² , YANG Kehu ² ,  YU Qin ¹

1. Department of Respiratory Medicine, The First Hospital of Lanzhou University, Lanzhou, Gansu, 730000, China2. Evidence-based Medicine Center of Lanzhou University, Lanzhou, Gansu, 730000, China;

Corresponding author：

YU Qin, Email: YUQ701@163.com

Keywords：

Pleural neoplasms; Malignant pleural mesothelioma; Raltitrexed; Cisplatin; Systematic review

DOI：

10.7507/1672-2531.20080008

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Objective　 To systematically evaluate the clinical effectiveness and safety of raltitrexed plus cisplatin in the treatment of malignant pleural mesothelioma (MPM) when compared with other chemotherapy regimens.
Methods　 We electronically searched PubMed, Embase, The Cochrane Library and Chinese Biomedicine Database to March, 2007. Randomized controlled trials (RCTs) and quasi-RCTs were identified, and Revman 4.2.10 was applied for statistical analyses.
Results　 One RCT involving 250 patients was included, which compared raltitrexed plus cisplatin versus cisplatin alone in the treatment of MPM. In the intention-to-treat population, the median survival time was statistically longer in the raltitrexed plus cisplatin group as compared to cisplatin alone group. (11.4 versus 8.8 months, P=0.048). The incidence of grade 3/4 toxicities was similar between the two groups.
Conclusion　 The current evidence available showed that, the combination of raltitrexed and cisplatin may prolong the survival time for MPM patients, with a low incidence of grade 3/4 toxicities. However, more high-quality RCTs are required to further define its clinical effectiveness.

Citation： YANG Shukun,TIAN Jinhui,YANG Kehu,YU Qin. Raltitrexed plus Cisplatin for Malignant Pleural Mesothelioma: A Systematic Review. Chinese Journal of Evidence-Based Medicine, 2008, 08(1): 32-35. doi: 10.7507/1672-2531.20080008 Copy

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3.	Robinson BWS, MuskAW, Lake RA. Malignant Mesothelioma. Lancet, 2005, 366(9483): 397-408.
4.	Sterman D, Albelda S. Advances in the diagnosis, evaluation and management of malignant pleural mesothelioma. Respirology, 2005, 10(3): 266-283.
5.	Steele JPC, Klabatsa A. Chemotherapy options and new advances in malignant pleural mesothelioma. Ann Oncol, 2005, 16(3): 345-351.
6.	van Meerbeeck JP, Baas P, Debruyne C, et al. A phase II EORTC study of temozolomide in patients with malignant pleural mesothelioma. Eur J Cancer, 2002, 38(6): 779-783.
7.	Berghmans T, Paesmans M, Lalami Y, et al. Activity of chemotherapy and immunotherapy on malignant mesothelioma: A systematic review of the literature with meta-analysis. Lung Cancer, 2002, 38(2): 111-121.
8.	Jackman AL, Taylor GA, Gibson W, et al. ICI D1694, a quinazoline antifolate thymidylate synthase inhibitor that is a potent inhibitor of L1210 tumor cell growth in vitro and in vivo: A new agent for clinical study. Cancer Res, 1991, 51(20): 5579-5586.
9.	Baas P, Ardizzoni A, Grossi F, et al. The activity of raltitrexed (Tomudex) in malignant pleural mesothelioma: An EORTC phase II study (08992). Eur J Cancer, 2003, 39(3): 353-357.
10.	Fizazi K, Doubre H, Le Chevalier T, et al. Combination of raltitrexed and oxaliplatin is an active regimen in malignant mesothelioma: Results of a phase II study. J Clin Oncol, 2003, 21(2): 349-354.
11.	van Meerbeeck JP, Gaafar R, Manegold C, et al. Randomized Phase III Study of Cisplatin With or Without Raltitrexed in Patients With Malignant Pleural Mesothelioma: An Intergroup Study of the European Organisation for Research and Treatment of Cancer Lung Cancer Group and the National Cancer Institute of Canada. J Clin Oncol, 2005, 23(28): 6881-6889.
12.	Alderson P, Green S, Higgins JPT. Cochrane Reviews Handbook 4.2.6 [Update September 2006]. Available from: URL: http://www.cochrane.org/resources/handbook/.
13.	Bottomley A, Gaafar R, Manegold C, et al. Short-term treatment-related symptoms and quality of life: results from an international randomized phase III study of cisplatin with or without raltitrexed in patients with malignant pleural mesothelioma: an EORTC Lung-Cancer Group and National Cancer Institute, Canada, Intergroup Study. J Clin Oncol, 2006, 24(9): 1435-1442.

1. Travis WD, Brambilla E, Muller-Hermelink HK, et a1. World Health Organization classification of tumours. Pathology ＆genetics tumours of the lung, pleural, thymus and heart. Lyon: IARC Press, 2004．.
2. de Klerk NH, Olsen N, Threlfall T, et al. Mesothelioma survival in Western Australia. Perth: 1st Perth Mesothelioma Centre Symposium, 2004.
3. Robinson BWS, MuskAW, Lake RA. Malignant Mesothelioma. Lancet, 2005, 366(9483): 397-408.
4. Sterman D, Albelda S. Advances in the diagnosis, evaluation and management of malignant pleural mesothelioma. Respirology, 2005, 10(3): 266-283.
5. Steele JPC, Klabatsa A. Chemotherapy options and new advances in malignant pleural mesothelioma. Ann Oncol, 2005, 16(3): 345-351.
6. van Meerbeeck JP, Baas P, Debruyne C, et al. A phase II EORTC study of temozolomide in patients with malignant pleural mesothelioma. Eur J Cancer, 2002, 38(6): 779-783.
7. Berghmans T, Paesmans M, Lalami Y, et al. Activity of chemotherapy and immunotherapy on malignant mesothelioma: A systematic review of the literature with meta-analysis. Lung Cancer, 2002, 38(2): 111-121.
8. Jackman AL, Taylor GA, Gibson W, et al. ICI D1694, a quinazoline antifolate thymidylate synthase inhibitor that is a potent inhibitor of L1210 tumor cell growth in vitro and in vivo: A new agent for clinical study. Cancer Res, 1991, 51(20): 5579-5586.
9. Baas P, Ardizzoni A, Grossi F, et al. The activity of raltitrexed (Tomudex) in malignant pleural mesothelioma: An EORTC phase II study (08992). Eur J Cancer, 2003, 39(3): 353-357.
10. Fizazi K, Doubre H, Le Chevalier T, et al. Combination of raltitrexed and oxaliplatin is an active regimen in malignant mesothelioma: Results of a phase II study. J Clin Oncol, 2003, 21(2): 349-354.
11. van Meerbeeck JP, Gaafar R, Manegold C, et al. Randomized Phase III Study of Cisplatin With or Without Raltitrexed in Patients With Malignant Pleural Mesothelioma: An Intergroup Study of the European Organisation for Research and Treatment of Cancer Lung Cancer Group and the National Cancer Institute of Canada. J Clin Oncol, 2005, 23(28): 6881-6889.
12. Alderson P, Green S, Higgins JPT. Cochrane Reviews Handbook 4.2.6 [Update September 2006]. Available from: URL: http://www.cochrane.org/resources/handbook/.
13. Bottomley A, Gaafar R, Manegold C, et al. Short-term treatment-related symptoms and quality of life: results from an international randomized phase III study of cisplatin with or without raltitrexed in patients with malignant pleural mesothelioma: an EORTC Lung-Cancer Group and National Cancer Institute, Canada, Intergroup Study. J Clin Oncol, 2006, 24(9): 1435-1442.

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Raltitrexed plus Cisplatin for Malignant Pleural Mesothelioma: A Systematic Review

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