CASE REPORTSEfficacy of a combination of pemetrexed and multiple redo-surgery in an 11-year-old girl with a recurrent multifocal abdominal mesotheliomaMilano, Emiliea; Pourroy, Bertranda; Rome, Angéliqueb; Delarue, Arnauldc; Coze, Caroleb; Gorincour, Guillaumed; Bouvier, Corinnee; Braguer, Dianea; André, NicolasbAuthor Information Departments of aPharmacy bPaediatric Oncology cPaediatric Surgery dPaediatric Radiology ePathology, Children Hospital of ‘la Timone’, Marseille, France Correspondence to N. André, Department of Paediatric Oncology, Children Hospital of ‘la Timone’, 13385 Marseille cedex 05, France. Tel: +33 491 386 828; fax: +33 491 386 832; e-mail: [email protected] Received 10 June 2006 Revised form accepted 29 July 2006 Anti-Cancer Drugs: November 2006 - Volume 17 - Issue 10 - p 1231-1234 doi: 10.1097/01.cad.0000236312.50833.a7 Buy Metrics Abstract We report the case of an 11-year-old girl with a recurrent progressive locally advanced abdominal mesothelioma. First, there was an incomplete surgical resection without any complementary chemotherapy, followed by a slow progression of the disease. Three years later, after two macroscopically complete surgical resections of peritoneal and ovarian tumors, she failed to respond to treatment with gemcitabin–carboplatin and gemcitabin–cisplatin, and developed splenic tumors and large multicystic hepatic tumors. She was then treated with pemetrexed. The schedule of chemotherapy was pemetrexed 400 mg intravenously plus cisplatin 60 mg once every 3 weeks associated with folic acid and vitamin B12. The tumor reduction was evaluated with positron emission tomography scan and tomodensitometry every three courses. Chemotherapy tolerance was good apart from a grade III neutropenia at the second course, a fever of unknown origin at the fifth course and a grade III thrombocytopenia at the sixth course. As tolerance and clinical responses were good, pemetrexed posology was increased up to 10%. After six courses, hepatic and splenic lesion tumors were initially diminished and then stablilized. Thus, a surgical resection was attempted: a first surgery followed by a second one 3 days later allowed completion of a difficult left hepatectomy, and resection of the hilum and splenic tumors. Fourteen months after the surgery, the girl remained in partial remission with stable disease. So far, pemetrexed associated with cisplatin revealed a good tolerance and promising results regarding its antitumoral efficacy in a progressive metastatic abdominal mesothelioma in childhood. © 2006 Lippincott Williams & Wilkins, Inc.