Primary Outcome Measures
- CD 74 and VEGF detection effect on response to treatment [ Time Frame: Essay done before starting treatment and correlated with the response ]
The paraffin blocks of the patients will be tested for CD74 and VEGF before starting treatment using IHC and the results will be correlated with the outcome of treatment during evaluation.
All MPM samples will be subjected to immunohistochemistry with CD74 and VEGF antibodies.
The VEGF will be scored using a 0-3 scoring system to represent the percentage of cytoplasmic positively stained cells in the tumor portion, as follows: 0-10%, 11-30%, 31-60% and 61-100% positive staining correspond to score 0, 1, 2 and 3 respectively. Both CD74 and VEGF immunohistochemical markers will be furtherly categorized in the statistical analyses as none (0)/low (1) vs medium (2)/high expression(3).
The CD74 expression will be recorded in the tumor and the stroma semiquantitatively using the histoscore method using four representative fields with the final score resulting from the percentage of tumor cells staining positively multiplied by the staining intensity grade.
Eligibility
- Inclusion Criteria
- Histologic or cytologic diagnosis of malignant pleural Mesothelioma
- No prior chemotherapy.
- ECOG less than or equal to 2 .
- Measurable disease according to the requirements of SWOG criteria.
- Age > or equal to 19 years .
- Estimated life expectancy of at least 12 weeks .
- Adequate bone marrow reserve (white blood cells [WBC] > or equal to 3.5 × 109 /L, neutrophils > or equal to 1.5 × 109 /L, platelets > or equal to 100 × 109 /L, and hemoglobin > or equal to 9.0 gm/dL).
- No prior chemotherapy.
- Exclusion Criteria
- Presence of central nervous system metastases.
- Inadequate liver function (bilirubin > 1.5 times upper normal limit [UNL] and alanine transaminase [ALT] or aspartate transaminase [AST] > 3.0 UNL or up to 5.0 UNL in the presence of hepatic metastases).
- Inadequate renal function (creatinine > 1.25 times UNL, creatinine clearance < 50mL/min).
- Serious concomitant systemic disorder incompatible with the study.
- Second primary malignancy (except in situ carcinoma of the cervix, adequately treated basal cell carcinoma of the skin, T1 vocal cord cancer in remission, or prior malignancy treated more than 5 years prior to enrollment without recurrence).
- Pregnancy
- Inadequate liver function (bilirubin > 1.5 times upper normal limit [UNL] and alanine transaminase [ALT] or aspartate transaminase [AST] > 3.0 UNL or up to 5.0 UNL in the presence of hepatic metastases).
