Repetitive responses to nanoparticle albumin-bound paclitaxel and carboplatin in malignant pleural mesothelioma

Our plain-English summary of Repetitive responses to nanoparticle albumin-bound paclitaxel and carboplatin in malignant pleural mesothelioma, by O. Kanai, K. Fujita, K. Nakatani, et al (Respirology Case Reports, 2016).

The study

• Authors: O. Kanai, K. Fujita, K. Nakatani, T. Mio
• Journal: Respirology Case Reports
• Published: 2016;4(1):28-31
• Type of article: Case report
• Cited by: 9 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Malignant pleural mesothelioma (MPM) is a rare tumor with a poor prognosis. Although cisplatin plus pemetrexed is the standard chemotherapy for patients with unresectable MPM, few agents are available for MPM patients who do not tolerate pemetrexed. Here, we report the first case of an MPM patient for whom the combination of nanoparticle albumin-bound paclitaxel and carboplatin (nabPC) repetitively achieved tumor regression. A 76-year-old man was diagnosed with epithelioid MPM. One cycle of carboplatin plus pemetrexed and two cycles of gemcitabine were administered but failed to inhibit tumor progression. By contrast, four cycles of nabPC resulted in a good response. Upon disease progression, four cycles of nabPC were performed again and resulted in a modest response. In conclusion, based on the present case, nabPC is a potential alternative chemotherapeutic agent for MPM, especially for MPM patients who do not tolerate pemetrexed.

In plain English

This case report from Kyoto, Japan, described a 76-year-old man with a 35-pack-year smoking history and a history of asbestos exposure. Asbestos type was not reported. A pleural biopsy showed epithelioid malignant pleural mesothelioma; after a PET-CT scan showed spread to chest lymph nodes, including on the opposite side, he was diagnosed with stage IV (pT2N3M0). He had no surgery or radiotherapy. His first chemotherapy, carboplatin plus pemetrexed, was stopped after one cycle because of a grade 3 skin rash. After two cycles of gemcitabine, the tumor had grown. He then received carboplatin with nanoparticle albumin-bound paclitaxel (nabPC). Scans showed drastic decreases in the tumor. This treatment was stopped by the fourth cycle because of worsening nerve damage (peripheral sensory neuropathy). He then stayed progression-free for 5 months. When the disease grew again, nabPC was given again for four cycles. It produced a modest decrease without grade 3 or 4 blood-related side effects; neuropathy again ended treatment. The authors concluded that this case suggests nabPC is a potential alternative chemotherapy, especially for patients who do not tolerate pemetrexed.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: case report (one patient)
• Who was studied: one 76-year-old man with a 35-pack-year smoking history, treated at the National Hospital Organization Kyoto Medical Center, Japan; dates of treatment not given
• Exposure: history of asbestos exposure (fiber type, job and dose not reported); the treatment studied was carboplatin (target AUC 6 mg/mL/min, day 1) plus nab-paclitaxel 100 mg/m2 on days 1, 8 and 15 every 4 weeks
• Main results:
  • Immunohistochemical staining of the pleural biopsy samples indicated epithelioid malignant pleural mesothelioma
  • PET-CT showed multiple metastases in the mediastinal lymph nodes, including the contralateral nodes, and the patient was diagnosed with stage IV (pT2N3M0) disease
  • First-line carboplatin plus pemetrexed was withdrawn after the first cycle because of a grade 3 maculopapular rash
  • After two cycles of gemcitabine, CT showed tumor progression
  • With carboplatin plus nab-paclitaxel, interlobular nodules and pleural thickness decreased drastically; worsening peripheral sensory neuropathy led to withdrawal by the fourth cycle
  • The patient remained progression free for 5 months after the first nabPC course
  • Rechallenge with nabPC at the same dose gave a modest decrease in pleural thickness and interlobular nodules, without grade 3 or 4 hematological adverse effects; neuropathy again led to withdrawal by the fourth cycle
• The authors' conclusion: The authors concluded that the case suggests nabPC is a potential alternative chemotherapy agent for malignant pleural mesothelioma, especially for patients who do not tolerate pemetrexed

Topics

Medical terms in this study, explained in our Lexicon: Carboplatin, Pleural Mesothelioma, Prognosis, Cisplatin, Pemetrexed (Alimta), Chemotherapy, Unresectable, Epithelioid.

Related studies

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• Two-Step Delivery: Exploiting the Partition Coefficient Concept to Increase Intratumoral Paclitaxel Concentrations In vivo Using Responsive Nanoparticles — A.H. Colby, R. Liu, et al. (2016)
• Paclitaxel-loaded expansile nanoparticles in a multimodal treatment model of malignant mesothelioma — M.D. Schulz, K.A. Zubris, et al. (2011)
• Dose-Response Relationships for Lung Tumor and Pleural Mesothelioma Induction by Repetitive Intratracheal Instillation of a Multiwalled Carbon Nanotube, MWCNT-7, in Rats: Comparison with Inhalation Carcinogenicity Based on Lung Burden — A. Maeno, M. Hojo, et al. (2026)
• A pathological complete response in malignant pleural mesothelioma after combination chemotherapy with Carboplatin and pemetrexed — S.C. Kao, B. McCaughan, et al. (2010)

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