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Current Treatment Options in Oncology
Published in: Current Treatment Options in Oncology 4/2014

01-12-2014 | Lung Cancer (HA Wakelee, Section Editor)

Local and Systemic Therapies for Malignant Pleural Mesothelioma

Authors: Daniel Gomez, MD, Anne S. Tsao, MD

Published in: Current Treatment Options in Oncology | Issue 4/2014

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Opinion statement

Malignant pleural mesothelioma (MPM) is a challenging disease to treat with median overall survival times ranging between 9-17 months for all stages of disease. Recent clinical trials have improved our understanding of the biology of MPM. However, survival results are still not ideal. For early-stage MPM, patients should be evaluated for trimodality therapy in an experienced cancer center. If treating off-protocol, MPM patients should receive a surgical staging evaluation. The decision to proceed with surgical resection also should be considered after an extensive and thorough pulmonary and cardiac evaluation. If deemed a good surgical candidate, patients should receive surgical resection (pleurectomy/decortication or extrapleural pneumonectomy), adjuvant radiation therapy (hemithoracic external beam or intensity modulated radiation therapy), and either neoadjuvant or adjuvant chemotherapy (cisplatin-pemetrexed for 4 cycles). The optimal precise sequence of the trimodality is unclear and should be decided upon by a multidisciplinary consensus for each individual patient. In general, clinical trial participation should be encouraged. Several trials are currently underway to examine intraoperative therapies, vaccines, immunotherapy additions, and novel radiation therapy techniques. Advances in the field of MPM are reliant on participation in clinical trials and identifying biomarkers that are predictive for response to systemic therapies and prognostic for survival benefit.
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Metadata
Title
Local and Systemic Therapies for Malignant Pleural Mesothelioma
Authors
Daniel Gomez, MD
Anne S. Tsao, MD
Publication date
01-12-2014
Publisher
Springer US
Published in
Current Treatment Options in Oncology / Issue 4/2014
Print ISSN: 1527-2729
Electronic ISSN: 1534-6277
DOI
https://doi.org/10.1007/s11864-014-0314-4

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