Is carboplatin/pemetrexed as effective as cisplatin/pem in treatment of unresectable malignant pleural mesothelioma in a patient with contraindication to cisplatin?

The combination of carboplatin/pemetrexed instead of cisplatin/pemetrexed is definitely reasonable in older mesothelioma patients and/or patients with comorbidities or concerns about poor tolerability to cisplatin. At least three phase 2 non-randomized studies evaluated the combination of carboplatin pemetrexed in patients with mesothelioma. In addition, the international expanded access program reported outcomes of patients that received with cisplatin or carboplatin in combination with pemetrexed. Results were comparable with either regimen. RR was slightly higher with cisplatin but TTP and one year survival were the same. A meta analysis and systemic review published in JCO by Srour et al showed OS and PFS was comparable in patients that...