Malignant Pleural Mesothelioma: Treatment Options and Novel Therapies

Abstract

Malignant pleural mesothelioma is a rare primary tumor rising from the pleura and is associated with exposure to asbestos fibers. Mesothelioma is a locally aggressive disease that usually presents at an advanced stage and has a median overall survival of 1 year. Treatment options rarely result in cure of disease and range from trimodality treatment, including chemotherapy, radiation, and surgery, to supportive care. In patients with limited local disease and good functional status, trimodality treatment with extra-pleural pneumonectomy, chemotherapy, and radiation is frequently employed. Best supportive care should be instituted for patients with metastatic disease and poor functional status. Palliative therapy focuses on control of pleural effusions with drainage techniques and pain with radiation therapy. Novel therapies are showing promise, including photodynamic therapy, immunotherapy, and molecular targeted therapy.

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J. Martin, B. Zwischenberger and T. Fabian, "Malignant Pleural Mesothelioma: Treatment Options and Novel Therapies," Journal of Cancer Therapy, Vol. 5 No. 1, 2014, pp. 60-66. doi: 10.4236/jct.2014.51008.

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1] M. J. Teta, P. J. Mink, E. Lau, B. K. Sceurman and E. D. Foster, “US Mesothelioma Patterns 1973-2002: Indicators of Change and Insights into Background Rates,” European Journal of Cancer Prevention, Vol. 17, No. 6, 2008, pp. 525-534. http://dx.doi.org/10.1097/CEJ.0b013e3282f0c0a2
[2] R. T. Lin, K. Takahashi, A. Karjalainen, et al., “Ecological Association between Asbestos-Related Diseases and Historical Asbestos Consumption: An International Analysis,” Lancet, Vol. 369, No. 9564, 2007, pp. 844-849. http://dx.doi.org/10.1016/S0140-6736(07)60412-7
[3] A. Linton, J. Vardy, S. Clarke and N. van Zandwijk, “The Ticking Time-Bomb of Asbestos: Its Insidious Role in the Development of Malignant Mesothelioma,” Critical Reviews in Oncology/Hematology, Vol. 84, No. 2, 2012, pp. 200-201. http://dx.doi.org/10.1016/j.critrevonc.2012.03.001
[4] N. J. Olsen, P. J. Franklin, A. Reid, et al., “Increasing Incidence of Malignant Mesothelioma after Exposure to Asbestos During Home Maintenance and Renovation,” Medical Journal of Australia, Vol. 195, No. 5, 2011, pp. 271-274. http://dx.doi.org/10.5694/mja11.10125
[5] D. W. Henderson, G. Reid, S. C. Kao, N. van Zandwijk and S. Klebe, “Challenges and Controversies in the Diagnosis of Mesothelioma: Part 1. Cytology-Only Diagnosis, Biopsies, Immunohistochemistry, Discrimination between Mesothelioma and Reactive Mesothelial Hyperplasia, and Biomarkers,” Journal of Clinical Pathology, Vol. 66, No. 10, 2013, pp. 847-853. http://dx.doi.org/10.1136/jclinpath-2012-201303
[6] D. Curran, T. Sahmoud, P. Therasse, et al., “Prognostic Factors in Patients with Pleural Mesothelioma: The European Organization for Research and Treatment of Cancer Experience,” Journal of Clinical Oncology, Vol. 16, No. 1, 1998, pp. 145-152.
[7] J. G. Edwards, K. R. Abrams, J. N. Leverment, et al., “Prognostic Factors for Malignant Mesothelioma in 142 Patients: Validation of CALGB and EORTC Prognostic Scoring Systems,” Thorax, Vol. 55, No. 9, 2000, pp. 731-735. http://dx.doi.org/10.1136/thorax.55.9.731
[8] S. M. Mikulski, J. J. Costanzi, N. J. Vogelzang, et al., “Phase II Trial of a Single Weekly Intravenous Dose of Ranpirnase in Patients with Unresectable Malignant Mesothelioma,” Journal of Clinical Oncology, Vol. 20, No. 1, 2002, pp. 274-281. http://dx.doi.org/10.1200/JCO.20.1.274
[9] N. van Zandwijk, G. Reid, A. Linton and S. Kao, “Radical Surgery for Malignant Pleural Mesothelioma: Have We Identified the Appropriate Selection Tools?” Annals of Cardiothoracic Surgery, Vol. 1, No. 4, 2012, pp. 481-486.
[10] V. Rusch, E. H. Baldini, R. Bueno, et al., “The Role of Surgical Cytoreduction in the Treatment of Malignant Pleural Mesothelioma: Meeting Summary of the International Mesothelioma Interest Group Congress, September 11-14, 2012, Boston, Mass,” Journal of Thoracic and Cardiovascular Surgery, Vol. 145, No. 4, 2013, pp. 909-910. http://dx.doi.org/10.1016/j.jtcvs.2013.01.039
[11] J. M. Thomas and A. I. Musani, “Malignant Pleural Effusions: A Review,” Clinics in Chest Medicine, Vol. 34, No. 3, 2013, pp. 459-471. http://dx.doi.org/10.1016/j.ccm.2013.05.004
[12] A. Levy, A. Assouline, S. Rivera, C. Chargari and P. Tai, “Role of Conservative (Palliative) Care-Only in the Management of Advanced Malignant Pleural Mesothelioma,” Anticancer Research, Vol. 32, No. 9, 2012, pp. 4025-4027.
[13] N. J. Vogelzang, J. J. Rusthoven, J. Symanowski, et al., “Phase III Study of Pemetrexed in Combination with Cisplatin versus Cisplatin Alone in Patients with Malignant Pleural Mesothelioma,” Journal of Clinical Oncology, Vol. 21, No. 14, 2003, pp. 2636-2644. http://dx.doi.org/10.1200/JCO. 2003.11.136
[14] A. Scherpereel, P. Astoul, P. Baas, et al., “Guidelines of the European Respiratory Society and the European Society of Thoracic Surgeons for the Management of Malignant Pleural Mesothelioma,” European Respiratory Journal, Vol. 35, No. 3, 2010, pp. 479-495. http://dx.doi.org/10.1183/0903 1936.00063109
[15] National Cancer Comprehensive Network, “NCCN Clinical Practice Guidelines in Oncology, Malignant Pleural Mesothelioma, v 1.2014,” 2013. http://www.nccn.org/professionals/physician_gls/f_guide lines.asp
[16] British Thoracic Society Standards of Care Committee, “BTS Statement on Malignant Mesothelioma in the UK, 2007,” Thorax, Vol. 62, Suppl. 2, 2007, pp. ii1-ii19.
[17] R. A. Stahel, W. Weder, Y. Lievens, et al., “Malignant Pleural Mesothelioma: ESMO Clinical Practice Guidelines for Diagnosis, Treatment and Follow-Up,” Annals of Oncology, Vol. 21, Suppl. 5, 2010. pp. v126-v128. http://dx.doi.org/10.1093/annonc/mdq173
[18] G. L. Ceresoli, P. A. Zucali, M. Mencoboni, et al., “Phase II Study of Pemetrexed plus Carboplatin in Malignant Pleural Mesothelioma,” Journal of Clinical Oncology, Vol. 24, No. 9, 2006, pp. 1443-1448. http://dx.doi.org/10.1200/JCO.2005.04.3190
[19] M. F. Muers, R. J. Stephens, P. Fisher, et al., “Active Symptom Control with or without Chemotherapy in the Treatment of Patients with Malignant Pleural Mesothelioma (MS01): A Multicentre Randomised Trial,” Lancet, Vol. 371, No. 9625, 2008, pp. 1685-1694. http://dx.doi.org/10.1016/S0140-6736 (08)60727-8
[20] E. A. Eisenhauer, W. K. Evans, N. Murray, et al., “New Response Evaluation Criteria in Solid Tumours: Revised RECIST Guideline (Version 1.1),” European Journal of Cancer, Vol. 45, No. 2, 2009, pp. 228-247. http://dx.doi.org/10.1016/j.ejca.2008.10.026
[21] A. S. Tsao, L. Garland, M. Redman, et al., “A Practical Guide of the Southwest Oncology Group to Measure Malignant Pleural Mesothelioma Tumors by RECIST and Modified RECIST Criteria,” Journal of Thoracic Oncology, Vol. 6, No. 3, 2011, pp. 598-560. http://dx.doi.org/10.1097/JTO.0b013e31820 8c83d
[22] E. G. Butchart, T. Ashcroft, W. C. Barnsley and M. P. Holden, “Pleuropneumonectomy in the Management of Diffuse Malignant Mesothelioma of the Pleura. Experience with 29 Patients,” Thorax, Vol. 31, No. 1, 1976, pp. 15-24. http://dx.doi.org/10.1136/thx.31.1.15
[23] D. Rice, “Standardizing Surgical Treatment in Malignant Pleural Mesothelioma,” Annals of Cardiothoracic Surgery, Vol. 1, No. 4, 2012, pp. 497-501.
[24] P. E. van Schil, P. Baas, R. Gaafar, et al., “Trimodality Therapy for Malignant Pleural Mesothelioma: Results from an EORTC Phase II Multicentre Trial,” European Respiratory Journal, Vol. 36, No. 6, 2010, pp. 1362-1369. http://dx.doi.org/10.1183/09031936.00039510
[25] T. Treasure, L. Lang-Lazdunski, D. Waller, et al., “ExtraPleural Pneumonectomy versus No Extra-Pleural Pneumonectomy for Patients with Malignant Pleural Mesothelioma: Clinical Outcomes of the Mesothelioma and Radical Surgery (MARS) Randomised Feasibility Study,” Lancet Oncology, Vol. 12, No. 8, 2011, pp. 763-772. http://dx.doi.org/10.1016/S1470-2045(11)70149-8
[26] V. W. Rusch, K. Rosenzweig, E. Venkatraman, et al., “A Phase II Trial of Surgical Resection and Adjuvant High-Dose Hemithoracic Radiation for Malignant Pleural Mesothelioma,” Journal of Thoracic and Cardiovascular Surgery, Vol. 122, No. 4, 2001, pp. 788-795. http://dx.doi.org/10.1067/mtc. 2001.116560
[27] V. Gupta, L. M. Krug, B. Laser, et al., “Patterns of Local and Nodal Failure in Malignant Pleural Mesothelioma after Extrapleural Pneumonectomy and Photon-Electron Radiotherapy,” Journal of Thoracic Oncology, Vol. 4, No. 6, 2009, pp. 746-750. http://dx.doi.org/10.1097/JTO.0b013e3181 a5292c
[28] ClinicalTrials.gov, 2013. http://clinicaltrials.gov/ct2/results?term=mesothelioma
[29] J. S. Friedberg, “Radical Pleurectomy and Photodynamic Therapy for Malignant Pleural Mesothelioma,” Annals of Cardiothoracic Surgery, Vol. 1, No. 4, 2012, pp. 472-480.
[30] J. S. Friedberg, M. J. Culligan, R. Mick, et al., “Radical Pleurectomy and Intraoperative Photodynamic Therapy for Malignant Pleural Mesothelioma,” Annals of Thoracic Surgery, Vol. 93, No. 5, 2012, pp. 1658-1665. http://dx.doi.org/10.1016/j.athoracsur.2012.02.009
[31] V. Rusch, L. Saltz, E. Venkatraman, et al., “A Phase II Trial of Pleurectomy/Decortication Followed by Intrapleural and Systemic Chemotherapy for Malignant Pleural Mesothelioma,” Journal of Clinical Oncology, Vol. 12, No. 6, 1994, pp. 1156-1163.
[32] P. H. Sugarbaker, O. A. Stuart and C. Eger, “Pharmacokinetics of Hyperthermic Intrathoracic Chemotherapy Following Pleurectomy and Decortication,” Gastroenterology Research and Practice, Vol. 2012, 2012, Article ID: 471205. http://dx.doi.org/10.1155/2012/471205
[33] W. Weder and I. Opitz, “Multimodality Therapy for Malignant Pleural Mesothelioma,” Annals of Cardiothoracic Surgery, Vol. 1, No. 4, 2012, pp. 502-507.
[34] J. Villena-Vargas and P. S. Adusumilli, “Mesothelin-Targeted Immunotherapies for Malignant Pleural Mesothelioma,” Annals of Cardiothoracic Surgery, Vol. 1, No. 4, 2012, pp. 466-471.
[35] R. J. Kelly, E. Sharon, I. Pastan and R. Hassan, “Mesothelin-Targeted Agents in Clinical Trials and in Preclinical Development,” Molecular Cancer Therapeutics, Vol. 11, No. 3, 2012, pp. 517-525.
http://dx.doi.org/10.1158/1535-7163.MCT-11-0454
[36] E. L. Kwak, Y. J. Bang, D. R. Camidge, et al., “Anaplastic Lymphoma Kinase Inhibition in Non-Small-Cell Lung Cancer,” New England Journal of Medicine, Vol. 363, No. 18, 2010, pp. 1693-1703.
http://dx.doi.org/10.1056/NEJMoa1006448
[37] A. K. Nowak, “Chemotherapy for Malignant Pleural Mesothelioma: A Review of Current Management and a Look to the Future,” Annals of Cardiothoracic Surgery, Vol. 1, No. 4, 2012, pp. 508-515.

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