Trial of Chemoimmunotherapy for Malignant Diffuse Pleural Mesothelioma-A Case Report

A 54-year-old man with histologically proved pleural diffuse mesothelioma was presented. The patient was treated with intrapleural administration of normal allogeneic lymphocytes (3-5 x 108 cells) and BCG-CWS in combination with a multiple drug regimens consisting of AVF (ACNU 2-2.5mg/kg on day 1, vincristine 0.02mg/kg FT-207 16mg/kg, on day 1, 8 and 15, respectively) therapy on a 6 week cycle, which was associated by stabilization of the chest film, no pleural effusion and improvement in pain. However, he relapsed 3 weeks after 2 cycles of AVF therapy. Adriamycin (1.2-1.5mg/kg, i. v. every 3-4 weeks) was restarted in combination with intrapleural administration of BCG-CWS, and a marked improvement on the chest X-ray with no pleural effusion was obtained. However, immunological monitoring showed impaired immune reactivity during the clinical course. Adriamycin and BCG-CWS administrations were stopped after a cumulative dose of 380mg and 5.4mg respectively. He is in remission state in excess of 16 months from the onset time of symptoms. This regimen of intrapleural BCG-CWS administration in combination with chemotherapy reems to have a worthwhile antitumor effect and thereby stabilize diffuse pleural mesothelioma.