AI Article Synopsis
- Pseudomyxoma peritonei (PMP) is a rare tumor known for its slow growth and resistance to chemotherapy, with the main curative option being cytoreductive surgery followed by hyperthermic intraperitoneal chemotherapy (HIPEC).
- A study was conducted on patients with relapsed or unresectable PMP, using a treatment regimen of mitomycin C (MMC), metronomic capecitabine, and bevacizumab, focusing on progression-free survival (PFS) and overall survival (OS).
- The results showed a median PFS of 17.9 months and manageable safety, indicating that this treatment regimen is promising for advanced PMP cases compared to historical data.
Article Abstract
Introduction: Pseudomyxoma peritonei (PMP) is a rare, slow growing tumor, traditionally considered chemoresistant. The only curative approach is cytoreductive surgery (CRS) followed by hyperthermic intraperitoneal chemotherapy (HIPEC). At disease relapse, or in patients with inoperable disease at diagnosis, no standard treatment has been defined, though nonrandomized series showed promising results with fluoropyrimidine-based regimens.
Patients And Methods: We conducted a prospective study in patients with relapsed or unresectable PMP and confirmed disease progression at baseline. Patients received MMC (7 mg/m every 6 weeks, up to a maximum of 4 cycles) plus metronomic capecitabine (625 mg/sqm/day b.i.d.) and bevacizumab (7.5 mg/kg every 3 weeks) until disease progression, unacceptable toxicity, or consent withdrawal. Primary endpoint was progression-free survival (PFS); secondary endpoints were overall survival (OS), overall response rate according to RECIST v1.1 criteria, serum markers response and safety.
Results: Fifteen patients were included. At a median follow-up of 26.1 months (IQR, 17.7-49.6), median PFS was 17.9 months (95% CI, 11.0-NE), with 1-year PFS and OS rates of 73% and 87%. Safety profile was manageable, with only 13% G3/G4 treatment-related adverse events.
Conclusion: Metronomic capecitabine, bevacizumab, and MMC are an active regimen in advanced and progressive PMP and favorably compares with historical series.
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| http://dx.doi.org/10.1016/j.clcc.2023.08.005 | DOI Listing |
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