Vol 33, No 15_suppl (May 20 Supplement), 2015: e18544
© 2015 American Society of Clinical Oncology
Mesothelioma in the United States: A Surveillance, Epidemiology and End Results (SEER)-Medicare investigation of treatment patterns and survival.
Jennifer Lynn Beebe-Dimmer, Cecilia Yee, Tapashi Dalvi, Jon Fryzek, David Garabrant, Ann G. Schwartz and Shirish M. Gadgeel
Karmanos Cancer Inst Onc Wayne State School of Medcn, Detroit, MI; Karmanos Cancer Institute Division of Population Studies and Disparities Research, Detroit, MI; MedImmune, LLC, Gaithersburg, MD; EpidStat Inc, Ann Arbor, MI; EpidStat Inc., Ann Arbor, MI; Karmanos Cancer Institute, Wayne State University, Detroit, MI; Karmanos Cancer Inst/Wayne State Univ, Detroit, MI
Background: Mesothelioma is a rare malignancy typically associated with exposure to asbestos and poor survival. The purpose of this investigation was to describe mesothelioma patient characteristics, treatment patterns and survival, both overall and according to treatment course utilizing the National Cancer Institute’s SEER-Medicare database.Methods: Patients in this study were diagnosed with malignant mesothelioma of the pleura, peritoneum or other site between 01/01/2005 and 12/31/2009 with follow-up for survival through 12/31/2010. We determined the distribution of patient and tumor characteristics at time of diagnosis, and subsequent treatment patterns (surgery, radiation and chemotherapy). Among patients treated with chemotherapy, we determined chemotherapy regimen and estimated survival by line of therapy. Results: Of the 1,625 patients considered eligible for this investigation, the median age at time of diagnosis was 78 years (age range; 66 to 103 years) and 78% were male. 30% of these patients had surgery and 45% were given chemotherapy. The median overall survival was 8 months (mos) (range 1-69 mos). The median survival of patients treated with surgery and chemotherapy (n = 249) was 14 mos and 5 mos among patients who received surgery but no chemotherapy (n = 237). Among non-surgical patients, the median survival among patients who received chemotherapy (n = 478) was 10 mos and patients who did not was 4 mos (n = 623). Among chemotherapy patients, the most commonly (68%) prescribed regimen for first line therapy was Cisplatin or Carboplatin (Ca/Ci) combined with Pemetrexed (Pe). Among those prescribed a second line therapy, retreatment with Ca/Ci + Pe was the most common treatment (33%).Conclusions: Mesothelioma patients receiving chemotherapy survive longer than patients who did not. The observational nature of this study makes it difficult to attribute differences in survival to regimen alone and may be explained by other patient-related factors.