Activity of chemotherapy and immunotherapy on malignant mesothelioma: a systematic review of the literature with meta-analysis

The role of chemotherapy for unresectable malignant mesothelioma is unclear. The aims of the present study were to evaluate the methodological quality of published papers relative to chemotherapy or immunotherapy in malignant mesothelioma and to aggregate, for trials having a similar methodology, th...

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Bibliographic Details
Published in:Lung cancer (Amsterdam, Netherlands) Netherlands), 2002-11, Vol.38 (2), p.111-121
Main Authors: Berghmans, T, Paesmans, M, Lalami, Y, Louviaux, I, Luce, S, Mascaux, C, Meert, A.P, Sculier, J.P
Format: Article
Language:English
Subjects:
Antineoplastic Combined Chemotherapy Protocols - therapeutic use
Biological and medical sciences
Chemotherapy
Cisplatin - administration & dosage
Clinical Trials as Topic
Doxorubicin - administration & dosage
Humans
Immunotherapy
Medical sciences
Mesothelioma
Mesothelioma - drug therapy
Mesothelioma - immunology
Mesothelioma - pathology
Meta-analysis
Pneumology
Prognosis
Quality score
Systematic review
Treatment Outcome
Tumors of the respiratory system and mediastinum
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Summary:The role of chemotherapy for unresectable malignant mesothelioma is unclear. The aims of the present study were to evaluate the methodological quality of published papers relative to chemotherapy or immunotherapy in malignant mesothelioma and to aggregate, for trials having a similar methodology, the response rates in order to identify the most active chemotherapeutic drugs and regimens. The literature relative to this topic, published between 1965 and June 2001 was reviewed. A methodological qualitative evaluation was performed according to the European Lung Cancer Working Party scale, specifically designed for phase II trials. A study was considered as potentially positive if the upper limit of the 95% confidence interval (CI) of the response rate was greater than 20% and positive if the lower limit of the 95% CI was >20%. Eighty-three studies (88 treatment arms) were eligible for the systematic review. Fifty-three arms were considered as positive or potentially positive. No statistically significant difference in the methodological quality was observed between negative and positive studies. Studies were aggregated in four groups according to the presence of cisplatin and/or doxorubicin in the treatment regimen. The combination of cisplatin and doxorubicin had the highest response rate (28.5%; P
ISSN:0169-5002
1872-8332
DOI:10.1016/S0169-5002(02)00180-0