Malignant mesothelioma is a disease which does not readily yield to chemotherapy. Therefore, a multi-institutional Phase II trial aimed to demonstrate the efficacy of dihydro-5-azacytidine (DHAC) in the treatment of malignant mesothelioma. Forty-one patients with histologically confirmed malignant mesothelioma received 120-hour continuous infusions of DHAC until maximal response, intolerable toxicity, or disease progression. One patient had a complete response, two had objective partial responses, and four had regression of evaluable disease. The overall response rate was 17%. The one complete responder remains without disease progression at 6 years. Chest pain and nausea were the most common toxicities. Conclusions: DHAC has definite antitumor activity. Caution regarding cardiac arrhythmias and pericardial effusion is necessary. "Dihydro-5-azacytidine in malignant mesothelioma. A phase II trial demonstrating activity accompanied by cardiac toxicity. Cancer and Leukemia Group B.", Vogelzang, et al., Cancer, 79(11):2237-42, June 1, 1997.
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