Recent progress in treatment of malignant pleural mesothelioma

Cancer Radiotherapie. 2005 Oct 7. [Link]

Mahe MA, Cellerin L, Michaud JL, Sagan C, Supiot S, Le Pechoux C.

Service de radiotherapie, centre Rene-Gauducheau, centre de lutte contre le cancer Nantes-Atlantique, boulevard Jacques-Monod, 44805 Saint-Herblain cedex, France.


Incidence of malignant pleural mesothelioma will rise until 2030-2040 because the elapsed time between exposure and diagnostic is up to several decades. Prognosis remains very poor with median survival less than one year and five-year survival not exceeding 5%. As compared to 1999, standard treatment adds chemotherapy with cisplatin and pemetrexed to local radiotherapy for prevention of local seeding after invasive diagnostic procedures. Despite various growth factors and their receptors are involved in malignant mesothelioma, first clinical trials of targeted therapies reported poor results. Multimodality therapy with extrapleural pneumonectomy and radiation therapy (+/-chemotherapy) can be of benefit in subgroups of patients but it cannot be recommended in a routine approach. As compared to bronchial carcinoma, inclusion of patients in clinical trials (using intensity-modulated radiation therapy) is the only way to somewhat improve results.