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Systemic drug therapy of malignant pleural mesothelioma
A Ardizzoni1, F Grossi, M C Pennucci
1Istituto Nazionale per la Ricerca sul Cancro, Division of Medical Oncology I, Genova, Italy.
Abstract:
Malignant pleural mesothelioma (MPM) is an uncommon malignancy characterized by a rapid clinical course. Few patients are possible candidates for radical surgery. According to most reviews, radiotherapy has a limited role in the treatment of MPM. The role of chemotherapy in the management of pleural mesothelioma still remains uncertain. The available data indicate that although 10-20% of patients are known to achieve on objective response to a number of chemotherapeutic agents, the impact on survival appears limited and improvement in the quality of life remains uncertain. The results of combination chemotherapy are comparable to those of single-agent chemotherapy and no major difference is detectable among the various combinations. Prospective phase II trials are recommended for the identification of new active treatments while large-scale randomized phase III trials are needed to identify the best available treatment. In addition, new standard criteria for eligibility and response assessment are required. This paper reviews the available literature on the systemic drug therapy of MPM.
Insights
Systemic chemotherapy offers limited survival benefits for malignant pleural mesothelioma (MPM). While some patients respond, overall impact on quality of life and survival remains uncertain for this rare cancer.
Area of Science:
- Oncology
- Thoracic Surgery
- Medical Oncology
Background:
- Malignant pleural mesothelioma (MPM) is a rare and aggressive cancer.
- Surgical options are limited for most MPM patients.
- Radiotherapy has a minimal role in MPM treatment.
Purpose of the Study:
- To review the available literature on systemic drug therapy for MPM.
- To evaluate the efficacy and role of chemotherapy in MPM management.
Main Methods:
- Systematic literature review of systemic drug therapy in MPM.
- Analysis of data on objective response rates and survival impact of chemotherapy.
Main Results:
- Chemotherapy shows limited impact on survival and quality of life in MPM.
- Objective response rates range from 10-20% with various chemotherapeutic agents.
- Combination chemotherapy offers no significant advantage over single-agent therapy.
Conclusions:
- The role of chemotherapy in MPM remains uncertain.
- Further research, including prospective phase II and large-scale randomized phase III trials, is needed.
- Development of new criteria for eligibility and response assessment is crucial.