Open Access Research article

Re-challenge with pemetrexed in advanced mesothelioma: a multi-institutional experience

Alessandra Bearz19*, Renato Talamini2, Gilda Rossoni3, Antonio Santo4, Vincenzo de Pangher5, Gianpiero Fasola6, Francesco Rosetti7, Adolfo Favaretto8, Vanesa Gregorc3, Massimiliano Berretta1, Sandra Santarossa1, Eleonora Berto1 and Umberto Tirelli1

Author Affiliations

1 Medical Oncology, IRCCS, Aviano, PN, Italy

2 Unit of Epidemiology and Biostatistics, IRCCS, Aviano, PN, Italy

3 Medical Oncology, IRCCS-S Raffaele, Milan, Italy

4 General Hospital, GIVOV, Verona, Italy

5 General Hospital, Gorizia, Italy

6 General Hospital Udine, Udine, Italy

7 General Hospital, Mirano, Italy

8 IOV Padova, Padova, Italy

9 National Cancer Institute of Aviano, Via Franco Gallini 2, Aviano, PN, 33081, Italy

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BMC Research Notes 2012, 5:482  doi:10.1186/1756-0500-5-482

Published: 3 September 2012



Although first-line therapy for patients affected by advanced mesothelioma is well established, there is a lack of data regarding the impact of second-line treatment.


We retrospectively collected data of patients affected by advanced mesothelioma, already treated with first-line therapy based on pemetrexed and platin, with a response (partial response or stable disease) lasting at least 6 months, and re-treated with a pemetrexed-based therapy at progression. The primary objective was to describe time to progression and overall survival after re-treatment.


Overall across several Italian oncological Institutions we found 30 patients affected by advanced mesothelioma, in progression after a 6-month lasting clinical benefit following a first-line treatment with cisplatin and pemetrexed, and re-challenged with a pemetrexed-based therapy. In these patients we found a disease control rate of 66%, with reduction of pain in 43% of patients. Overall time to progression and survival were promising for a second-line setting of patients with advanced mesothelioma, being 5.1 and 13.6 months, respectively.


In our opinion, when a patient has a long-lasting benefit from previous treatment with pemetrexed combined with a platin compound, the same treatment should be offered at progression.