Characteristics and long-term outcomes of advanced pleural mesothelioma in Latin America (MeSO-CLICaP).
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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, on behalf CLICaP
Аннотация
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.