Hemithoracic IMPRINT Safe for Locally Advanced Mesothelioma

Share this content:
Hemithoracic intensity-modulated pleural radiation therapy (IMPRINT) is safe and has an acceptable rate of radiation pneumonitis.
Hemithoracic intensity-modulated pleural radiation therapy (IMPRINT) is safe and has an acceptable rate of radiation pneumonitis.

Hemithoracic intensity-modulated pleural radiation therapy (IMPRINT) after chemotherapy and pleurectomy-decortication is safe and has an acceptable rate of radiation pneumonitis for the treatment of patients with malignant pleural mesothelioma, a study published in the Journal of Clinical Oncology has shown.1

For this phase 2 trial, researchers enrolled 45 patients at either Memorial Sloan Kettering Cancer Center in New York or MD Anderson Cancer Center in Houston, Texas. Patients received up to 4 cycles of chemotherapy with pemetrexed and a platinum agent. If feasible, pleurectomy-decortication was performed. Hemithoracic IMPRINT was then administered at a planned dose of 50.4 Gy in 28 fractions.

Of the 45 patients enrolled, 9 experienced disease progression before IMPRINT, 5 refused surgery or IMPRINT, 2 underwent an extrapleural pneumonectomy at the time of surgery, and 2 had chemotherapy complications.

In total, 26 patients received pemetrexed plus cisplatin, 18 had pemetrexed plus carboplatin, and 4 received a combination. Of those, 28.9% achieved a partial response, 33.3% experienced progressive disease, 1 patient died during chemotherapy, and all others had stable disease. Eight patients underwent pleurectomy-decortication or an extended version, and 13 underwent a partial pleurectomy-decortication. A total of 27 patients started hemithoracic IMPRINT.

Results showed that at a median follow-up of 21.6 months, 6 of the 27 evaluable patients experienced grade 2 radiation pneumonitis, and 2 patients experienced grade 3 radiation pneumonitis. Each recovered after the initiation of corticosteroids. No grade 4 or 5 radiation-related toxicities were observed.

RELATED: Age and Diabetes Linked With Neuropathy for Patients Undergoing Chemotherapy

Median progression-free survival was 12.4 months; median overall survival was 23.7 months. The 2-year overall survival rate was 59% and 25% among patients with resectable and unresectable tumors, respectively.

The findings suggest that incorporating hemithoracic IMPRINT with chemotherapy and pleurectomy-decortication creates a new lung-sparing treatment modality for patients with locally-advanced, malignant pleural mesothelioma.

Reference

  1. Rimner A, Zauderer MG, Gomez DR, Adusumilli PS, Parhar PK, Wu AJ, et al. Phase II study of hemithoracic intensity-modulated pleural radiation Therapy (IMPRINT) as part of lung-sparing multimodality therapy in patients with malignant pleural mesothelioma [published online ahead of print June 20, 2016]. J Clin Oncol. doi: 10.1200/JCO.2016.67.2675.

Related Resources

You must be a registered member of Cancer Therapy Advisor to post a comment.

Regimen and Drug Listings

GET FULL LISTINGS OF TREATMENT Regimens and Drug INFORMATION

Bone Cancer Regimens Drugs
Brain Cancer Regimens Drugs
Breast Cancer Regimens Drugs
Endocrine Cancer Regimens Drugs
Gastrointestinal Cancer Regimens Drugs
Gynecologic Cancer Regimens Drugs
Head and Neck Cancer Regimens Drugs
Hematologic Cancer Regimens Drugs
Lung Cancer Regimens Drugs
Other Cancers Regimens
Prostate Cancer Regimens Drugs
Rare Cancers Regimens
Renal Cell Carcinoma Regimens Drugs
Skin Cancer Regimens Drugs
Urologic Cancers Regimens Drugs

Sign Up for Free e-newsletters