Malignant pleural mesothelioma: overview of the North American and European experience

Kukreja, Jasleen; Jaklitsch, Michael T.; Wiener, Daniel C.; Sugarbaker, David J.; Burgers, Sjaak A.; Baas, Paul

doi:10.1016/j.thorsurg.2004.06.009

Cited by 25 publications

(13 citation statements)

References 60 publications

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“…However, clinical trials investigating new trends in the treatment of stage I and II malignant mesothelioma (http://www.mesotheliomaweb.org/clinical.htm) have shown promising prospects for both immunotherapy and systemic chemo-immunotherapy. 73,74 In addition, recent progress in early detection techniques also provides hope that patients can be treated efficiently, at an earlier stage, and with the possibility of monitoring. The majority concern a therapeutic approach using a surgery-radiotherapy combination associated with neoadjuvant chemotherapy.…”

Section: Multimodal and Immunotherapy Strategiesmentioning

confidence: 99%

What's the place of immunotherapy in malignant mesothelioma treatments?

Grégoire

2010

Cell Adhesion & Migration

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Malignant pleural mesothelioma (MPM) is a rare malignancy of the pleura with a very poor prognosis. Treatments evaluated for malignant mesothelioma, including chemotherapy, radiotherapy and surgery are of limited efficacy. However, the fact that the tumors of some patients with MPM regress spontaneously or respond to immunotherapy suggests that the immune system may respond to MPM under some circumstances. In this respect, animal studies have demonstrated immunoreactivity of MPM to different immunotherapies. In the case of MPM, several clinical studies have demonstrated a correlation between the presence of a lymphocyte infiltrate and a better prognosis and humoral response directed against specific antigens related to tumor. Thus, MPM immunotherapy is undoubtedly a highly promising but also very challenging approach to the treatment of this disease that has slipped through the defense lines of the immune system. This article reviews past and recent developments of the clinical strategies that concern immunotherapy of mesothelioma.

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Section: Multimodal and Immunotherapy Strategiesmentioning

confidence: 99%

What's the place of immunotherapy in malignant mesothelioma treatments?

Grégoire

2010

Cell Adhesion & Migration

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“…EPP offers a potential complete tumor resection, and adjuvant radiotherapy can be given at high dose. The number of operable MPM patients is still rather small; 20-30% of patients diagnosed with MPM are candidates for P/D or EPP at the time of diagnosis [40]. The role of surgery for MPM with the intension of cure continues to be a matter of debate [41]; however, EPP is the most effective therapy for achieving local control.…”

Section: Radiotherapy For Malignant Pleural Mesotheliomamentioning

confidence: 99%

Current therapies for malignant pleural mesothelioma

Nakano

2008

Environ Health Prev Med

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Mesothelioma is a highly lethal tumor derived from mesothelial cells, and its global incidence is increasing because of widespread exposure of numerous individuals to asbestos in the last 50 years. Mesothelioma is largely untreatable with any of the therapeutic modalities. Recently, a novel multitargeted antifolate pemetrexed has shown promising activity against malignant pleural mesothelioma, producing response rates of up to 40% when used in combination with cisplatin. In a large phase III study, use of a combination of pemetrexed and cisplatin was associated with significantly improved survival time and with greater antitumor activity compared with cisplatin alone. This combination also gave a significant response rate of approximately 50% in patients with epithelioid malignant pleural mesothelioma. These clinical benefits of pemetrexed-cisplatin doublet have changed the perception of mesothelioma chemotherapy. Other combinations, including gemcitabine in combination with cisplatin, have also shown encouraging response rates. Prognosis depends on gender, clinical stage of the tumor, histological subtype, platelet count, leukocyte counts, and performance status. Radiotherapy can palliate mesothelioma patients with chest pain, and has been indicated to be of benefit for the prevention of malignant seeding along the tract of a chest tube or needle biopsy. Trimodality treatment using extrapleural pneumonectomy, radiation and chemotherapy has shown promising therapeutic value. The development of chemotherapeutic regimens and the favorable outcomes of trimodality have led to new combined modality trials. In Japan, multicenter national trials against mesothelioma will begin in the near future.

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“…Due to the prevalence of metastatic disease at diagnosis and poor functional status, only 20% to 30% of patients diagnosed with MPM are candidates for PD or EPP at the time of diagnosis [7]. Because the surgical population is so limited, the greatest survival gains in MPM will likely lie with nonsurgical therapies.…”

Section: Surgerymentioning

confidence: 99%

New therapeutic options for mesothelioma

Goudar

2005

Curr Oncol Rep

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Malignant pleural mesothelioma is an aggressive thoracic tumor that is often refractory to chemotherapy and radiotherapy, making long-term survival a difficult goal. Although multimodality therapies, including cytoreductive surgery, chemotherapy, and radiotherapy, have been tested, their survival benefit is unclear. Recently, novel cytotoxic agents such as pemetrexed have shown promise in the treatment of malignant pleural mesothelioma, and in early trials new small-molecule agents targeted to the specific biochemical properties of this tumor have shown promise.

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Malignant pleural mesothelioma: overview of the North American and European experience

Cited by 25 publications

References 60 publications

What's the place of immunotherapy in malignant mesothelioma treatments?

What's the place of immunotherapy in malignant mesothelioma treatments?

Current therapies for malignant pleural mesothelioma

New therapeutic options for mesothelioma

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