This is very exciting news and demonstrates the possibility of patients achieving a complete response to chemotherapy prior to surgery. The patient was deemed to be Stage II pleural mesothelioma with epithelial histology. He had multiple biopsies that confirmed mesothelioma prior to the planned surgical procedure. Surgery(Pleurectomy decortication) was performed following 4 cycles of Pemetrexed ( Alimta) and carboplatin and when the specimens were sent to the pathology lab there was no remaining mesothelioma only tissue that had been adequately treated by his chemotherapy regimen. Though this is not a typical response it demonstrates the ability of chemotherapy to eradicate the tumor and hopefully this patient will remain in remission for a very long time.
We have included below the abstract for the case report.
A pathological complete response after preoperative chemotherapy with carboplatin and pemetrexed in malignant pleural mesothelioma: A case report.
Second Medical Oncology Unit, Istituto Oncologico Veneto, Via Gattamelata 64, Padova 35128, Italy;
Malignant pleural mesothelioma is an aggressive tumour with poor prognosis and short duration of response probably due to the high chemo-refractoriness. Multimodality treatment based on preoperative chemotherapy, surgery and adjuvant radiotherapy seems to be a feasible and effective therapeutic option in selected patients.We report on a case of pathological complete response in a patient affected by malignant pleural mesothelioma who was treated with four cycles of preoperative chemotherapy based on carboplatin plus pemetrexed followed by parietal pleurectomy and lung decortication. Carboplatin plus pemetrexed was a well tolerated regimen without grade 3-4 haematological toxicity, and this confirm the feasibility of such a treatment as an alternative to the current golden standard based on cisplatin plus pemetrexed.Complete resection allows the pathologist to better describe biological markers of mesothelioma cells, in order to select patients with different treatment outcome and prognosis.