Multidisciplinary treatment of malignant pleural mesothelioma

Giovanni Luca Ceresoli, Cesare Gridelli, Armando Santoro

Research output: Contribution to journalArticle

44 Citations (Scopus)

Abstract

The incidence of malignant pleural mesothelioma (MPM) is increasing worldwide, and is predicted to peak in the next 10-20 years. Difficulties in MPM diagnosis and staging, especially of early disease, have thwarted the development of a universally accepted therapeutic approach. Single modality therapies (surgery, radiotherapy, chemotherapy) have generally failed to significantly prolong patient survival. As a result, multimodality treatment regimens have been developed. Radical surgery with extrapleural pneumonectomy and adjuvant treatments has become the preferred option in early disease, but the benefits of such an aggressive approach have been questioned because of significant treatment-related morbidity and mortality. In the past few years, there have been several major advances in the management of patients with MPM, including more accurate staging and patient selection, improvements in surgical techniques and postoperative care, novel chemotherapy regimens with definite activity such as antifolate (pemetrexed or raltitrexed)-platinum combinations, and new radiotherapy techniques such as intensity-modulated radiation therapy. Induction chemotherapy followed by surgery and adjuvant radiotherapy has shown promising results. A number of molecular alterations occurring in MPM have been reported, providing broader insights into its biology and leading to the identification of new targets for therapy. However, currently available treatments still appear to have modest results. Further studies are needed to provide evidence-based recommendations for the treatment of early and advanced stages of this disease.

Original languageEnglish
Pages (from-to)850-863
Number of pages14
JournalThe oncologist
Volume12
Issue number7
DOIs
Publication statusPublished - Jul 2007

Fingerprint

Radiotherapy
Therapeutics
Pemetrexed
Folic Acid Antagonists
Drug Therapy
Adjuvant Radiotherapy
Induction Chemotherapy
Pneumonectomy
Malignant Mesothelioma
Postoperative Care
Platinum
Patient Selection
Morbidity
Survival
Mortality
Incidence
raltitrexed

Keywords

  • Malignant
  • Mesothelioma
  • Multimodality
  • Pleural
  • Treatment

ASJC Scopus subject areas

  • Cancer Research
  • Hematology

Cite this

Multidisciplinary treatment of malignant pleural mesothelioma. / Ceresoli, Giovanni Luca; Gridelli, Cesare; Santoro, Armando.

In: The oncologist, Vol. 12, No. 7, 07.2007, p. 850-863.

Research output: Contribution to journalArticle

Ceresoli, Giovanni Luca ; Gridelli, Cesare ; Santoro, Armando. / Multidisciplinary treatment of malignant pleural mesothelioma. In: The oncologist. 2007 ; Vol. 12, No. 7. pp. 850-863.
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