{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T15:20:07Z","timestamp":1785770407720,"version":"3.56.0"},"reference-count":18,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T00:00:00Z","timestamp":1784073600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T00:00:00Z","timestamp":1785715200000},"content-version":"vor","delay-in-days":19,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Malignant pleural mesothelioma (MPM) is an aggressive malignancy with poor prognosis, and the role of maintenance therapy after first-line platinum\u2013pemetrexed chemotherapy remains unclear. We conducted a multicenter retrospective study including 96 patients with metastatic or unresectable MPM treated across eight tertiary oncology centers. Eligible patients had received at least four cycles of first-line platinum\u2013pemetrexed and achieved disease control, after which they were either administered maintenance pemetrexed (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200954) or observed without further treatment (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200942). Maintenance pemetrexed was associated with significantly prolonged median progression-free survival (15.5 vs. 7.9 months;\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001) and overall survival (22.3 vs. 16.4 months;\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.002) compared with observation. Multivariate analyses confirmed maintenance pemetrexed as an independent predictor of improved progression-free survival (HR 2.92; 95% CI 1.81\u20134.72;\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001) and overall survival (HR 2.10; 95% CI 1.24\u20133.55;\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.005). Non-epithelioid histology was independently associated with worse outcomes. Subgroup analyses demonstrated that the survival benefit of maintenance pemetrexed persisted in patients achieving both partial response and stable disease after first-line chemotherapy. Importantly, maintenance therapy was well tolerated, with no discontinuations due to toxicity, highlighting its feasibility in routine practice. These real-world findings suggest that maintenance pemetrexed may be associated with improved survival outcomes in patients with MPM who achieve disease control after first-line therapy.\n                  <\/jats:p>","DOI":"10.1038\/s41598-026-61625-0","type":"journal-article","created":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T17:03:31Z","timestamp":1784135011000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Maintenance pemetrexed after platinum pemetrexed chemotherapy and survival outcomes in malignant pleural mesothelioma in a multicenter real world study"],"prefix":"10.1038","volume":"16","author":[{"given":"Okan","family":"Aydin","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zehra Sucuoglu","family":"Isleyen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mert","family":"Erciyestepe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmet Emin","family":"Ozturk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sermin Dinc","family":"Sonusen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tugay","family":"Atasever","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simay","family":"Cokgezer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ebru","family":"Cicek","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayse Gul Satman","family":"Durmaz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lamia Seker","family":"Can","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gozde Balkaya","family":"Aykut","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tuba","family":"Baydas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miray","family":"Aydogan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seval Ay","family":"Ersoy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammed Mustafa","family":"Atci","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kayhan","family":"Erturk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,15]]},"reference":[{"issue":"1","key":"61625_CR1","doi-asserted-by":"publisher","first-page":"73","DOI":"10.1007\/S00428-020-02980-9","volume":"478","author":"L Fernandez-Cuesta","year":"2021","unstructured":"Fernandez-Cuesta, L., Mangiante, L., Alcala, N. & Foll, M. 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