Successful Response to First-Line Carboplatin, Pemetrexed, and Bevacizumab for Peritoneal Mesothelioma: Two Case Reports

Abstract

Introduction: Peritoneal mesothelioma is an extremely rare malignancy of the peritoneum. It has a poor prognosis, and the optimal systemic chemotherapy remains controversial. Here, we report two cases of peritoneal mesothelioma with long-term survival and complete response to carboplatin, pemetrexed, and bevacizumab chemotherapy. Case Presentation: Both patients were treated with six cycles of carboplatin (AUC 5), pemetrexed (750 mg/m2), and bevacizumab (15 mg/kg) followed by pemetrexed and bevacizumab as maintenance therapy. Partial response continued for over 6 years in case 1, and complete response was obtained in case 2. The patient in case 1 died after 7 years due to accidental pneumonia, and the patient in case 2 remained disease-free for over 2 years after initiation of chemotherapy. Conclusion: Little information is available regarding angiogenesis in malignant peritoneal mesothelioma, and carboplatin/pemetrexed/bevacizumab are off-labeled chemotherapy by Japanese healthcare system as yet. However, our experience suggested that combined chemotherapy with bevacizumab is a feasible option for systemic chemotherapy in cases of peritoneal mesothelioma.