Treatments

A phase II study evaluating the cisplatin and epirubicin combination in patients with unresectable malignant pleural mesothelioma.
Lung Cancer. 2005 Oct

Few chemotherapeutic agents have demonstrated their efficacy in malignant mesothelioma. The cisplatin plus doxorubicin combination has one of the highest response rates. Epirubicin is an anthracyclin, analogous to doxorubicin, with a different toxicologic pattern. As there are no data on the activity of the combination cisplatin plus epirubicin in malignant mesothelioma, the European Lung Cancer Working Party (ELCWP) designed a phase II study with response rate as primary objective.Median survival was 13.3 months.Limited efficacy of imatinib mesylate in malignant mesothelioma: A phase II trial.
Lung Cancer. 2005 Oct

Twenty-five patients with histologically proven malignant mesothelioma participated in a trial of imatinib mesylate (Glivec) with a starting dose of 400mg per day taken orally, up to a maximal dose of 800mg. No responses were observed in the patient group, while three patients showed prolonged (>6 months) stabilization of disease. The median survival time was 398 days (range 88-840); the median time to progression was 63 days (range 29-275). Side effects of the medication were mild and included edema, nausea, constipation and diarrhea. We conclude that further investigation with monotherapy imatinib in mesothelioma is not warranted. More Information

Bowel Complications in 203 Cases of Peritoneal Surface Malignancies Treated With Peritonectomy and Closed-Technique Intraperitoneal Hyperthermic Perfusion.
Ann Surg Oncol. 2005 Sep 21

Peritonectomy and intraperitoneal hyperthermic perfusion (IPHP) are increasingly used in the management of carcinomatosis of various sites of origin. We analyzed the risk factors for bowel complications with primary anastomoses and the closed technique for IPHP.Bowel complications are not increased when primary unprotected anastomoses are performed during peritonectomy and IPHP when the closed technique is used. Male sex, duration of the procedure, and no previous systemic chemotherapy are independent unfavorable risk factors. More Information

A median sternotomy approach to right extrapleural pneumonectomy for mesothelioma.
Ann Thorac Surg. 2005 Sep

We assessed the feasibility of a median sternotomy approach as an alternative to thoracotomy in right-sided resections. Over a 15-month period, this approach was attempted in 10 cases. In 7 of them, the entire procedure was completed without additional thoracotomy access. There were no postoperative deaths in this group. At median follow-up of 8 months, we have not encountered tumor progression in the scars. More Information

Radiation recall dermatitis with pemetrexed.
Lung Cancer. 2005 Aug 16

Pemetrexed has recently been approved for use in combination with cisplatin as first-line chemotherapy for malignant pleural mesothelioma (MPM). Radiation therapy is frequently administered to the thoracic orifices and no data are available about the interactions between radiotherapy and pemetrexed. We report the first case of radiation recall dermatitis occurring after pemetrexed chemotherapy in a patient with MPM previously treated with radiation therapy to the thoracoscopy and drainage orificies.Pemetrexed could also act as a radiosensitizing agent that should be used with care for several weeks after radiotherapy. More Information

Gene therapy of mesothelioma.
Expert Opin Biol Ther. 2005 Aug

Despite improved diagnostic skills and new chemotherapeutic regimens, malignant mesothelioma (MM) remains a pathological disease with survival expectations after diagnosis remaining < 1 year. As the incidence of this disease has yet to peak, there is a pressing need for new therapeutic approaches. One such approach is gene therapy, which inserts 'therapeutic' genes into (generally) tumor cells seeking to induce tumor regression via a number of different theoretical mechanisms. This approach may be particularly relevant for mesothelioma as it is localized to body cavities and is readily accessible for biopsy sampling or for gene delivery. Furthermore, as MM patients rarely die from distant metastases, treating the primary tumor site may result in significant symptomatic and survival benefit. More Information

Triplet chemotherapy with cisplatin, gemcitabine and vinorelbine for malignant pleural mesothelioma.
Jpn J Clin Oncol. 2005 Aug

We investigated the use of triplet combination chemotherapy with cisplatin (CDDP), gemcitabine (GEM) and vinorelbine (VNR) for the treatment of Japanese patients with MPM [malignant pleural mesothelioma].The median survival time and survival rate at 2 years for all patients were 11 months and 50%, respectively. More Information

Hemithoracic radiation therapy after pleurectomy/decortication for malignant pleural mesothelioma.
Int J Radiat Oncol Biol Phys. 2005 Jul 28

Pleurectomy/decortication with adjuvant radiotherapy (RT) is not an effective treatment option for patients with MPM. Our results imply that residual disease cannot be eradicated with external RT with or without brachytherapy and that a more extensive surgery followed by external RT might be required to improve local control and overall survival. More Information

Photodynamic therapy as an adjunct to surgery for malignant pleural mesothelioma.
Lung Cancer. 2005 July

Malignant pleural mesothelioma (MPM) is increasingly observed in industrial countries. Despite concerted efforts and combined treatments including surgery, chemotherapy and irradiation patients eventually succumb from relentless local progression of the disease. Recent publications have demonstrated an improved response rate with the cytostatic agent pemetrexed which will be tested in a neoadjuvant setting followed by surgery. However, effective tumor control requires new loco-regional treatment modalities, eventually in combination with neoadjuvant chemotherapy. Intraoperative photodynamic therapy (PDT) of the chest cavity has been proposed as an attractive treatment concept for MPM since a selective treatment of the tumor bed following resection has the potential to improve local tumor control.Refinements of PDT for mesothelioma will depend on a more detailed understanding of the pathways for preferential sensitizer accumulation within the tumor as well as on synergistic effects between PDT and chemotherapeutic agents.