A catalogue of treatment and technologies for malignant pleural mesothelioma

Our plain-English summary of A catalogue of treatment and technologies for malignant pleural mesothelioma, by L.M. Schunselaar, J.M. Quispel-Janssen, J.J. Neefjes, et al (Expert Review of Anticancer Therapy, 2016).

The study

• Authors: L.M. Schunselaar, J.M. Quispel-Janssen, J.J. Neefjes, P. Baas
• Journal: Expert Review of Anticancer Therapy
• Published: 2016;16(4):455-63
• Type of article: Review
• Cited by: 10 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Malignant pleural mesothelioma is an aggressive fatal malignancy with a prognosis that has not significantly improved in the last decades. This review summarizes the current state of treatment and the various attempts that are made to improve overall survival for patients with malignant pleural mesothelioma. It also discusses technologies and protocols to test new and hopefully more effective compounds in a more individualized manner. These developments are expected to improve the prognosis for this group of patients.

In plain English

This article is a review, not a new study. The authors summarized published and ongoing research on treating malignant pleural mesothelioma, which they describe as associated with asbestos exposure. They described the standard first-line treatment, cisplatin combined with pemetrexed. In the cited phase III trial by Vogelzang et al., overall survival was 12.1 months with the combination versus 9.3 months with cisplatin alone. They reviewed later attempts, including growth-factor and blood-vessel-growth inhibitors, other targeted drugs, tumor-attacking viruses, immunotherapy and vaccines. In a cited phase III trial, among patients able to receive bevacizumab, overall survival was 18.8 months with bevacizumab added to pemetrexed and cisplatin versus 16.1 months with pemetrexed and cisplatin; the authors noted permitted second-line treatment may have affected this. The authors wrote that none of the many therapies tested in patients were effective in phase II trials. They also compared laboratory models: cell lines, cultures of patients' tumor cells, and mouse models. They noted that none of these models had been validated against the matching patient's response to chemotherapy. The authors concluded that several developments may finally lead to a step forward in treatment.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Narrative review of treatments, ongoing clinical trials and pre-clinical laboratory models for malignant pleural mesothelioma
• Who was studied: No new patients were studied. The review covers published clinical trials, ongoing phase II and III trials, and cell-based and mouse models of malignant pleural mesothelioma (MPM).
• Exposure: Not an exposure study. Asbestos appears only as background: the authors state MPM is associated with asbestos exposure, and they mention older mouse models in which tumors were induced with asbestos fibers. No fiber types are specified.
• Main results:
  • From a cited phase III trial (Vogelzang et al.), not this review: overall survival was 12.1 months for patients receiving cisplatin with pemetrexed versus 9.3 months for patients receiving cisplatin alone.
  • From a cited phase III trial, not this review: among patients able to receive bevacizumab, overall survival was 18.8 months in the pemetrexed/cisplatin/bevacizumab group versus 16.1 months in the pemetrexed/cisplatin group. Both groups received pemetrexed and cisplatin, and bevacizumab was added in one group.
  • The authors cautioned that second-line treatment was allowed in that bevacizumab trial and may have affected overall survival.
  • From cited studies: the EGFR inhibitors erlotinib, gefitinib and cetuximab showed no response in MPM.
  • From a cited phase I study of pembrolizumab: of 25 patients with MPM treated after first-line therapy, 7 had a partial response and 12 had stable disease.
  • The authors' overall assessment: none of the many therapies tested on patients with MPM were effective in phase II trials.
  • The authors noted that none of the pre-clinical models had been validated by matching chemotherapy response between the model and the corresponding patient.
• The authors' conclusion: The authors concluded that, although treatment prospects for MPM had not improved over the last decade, various developments may finally lead to a step forward in treatment. They named genome sequencing, drug screens on patients' tumor cells, and checkpoint-inhibitor immunotherapy.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Lung cancer, Mesothelioma.

Medical terms in this study, explained in our Lexicon: Pleural Mesothelioma, Prognosis, Overall Survival.

Related studies

• A review of bevacizumab in the treatment of malignant pleural mesothelioma — S. Brosseau, S. Assoun, et al. (2017)
• Oncolytic vaccinia virus as an adjuvant treatment to cytoreductive surgery for malignant peritoneal mesothelioma — S.A. Acuna, K. Ottolino-Perry, et al. (2014)
• Systemic approach to malignant pleural mesothelioma: what news of chemotherapy, targeted agents and immunotherapy? — D. Signorelli, M. Macerelli, et al. (2016)
• What's the place of immunotherapy in malignant mesothelioma treatments? — M. Grégoire (2010)
• Malignant pleural mesothelioma: update on treatment options with a focus on novel therapies — A.R. Haas, D.H. Sterman (2013)
• Gemcitabine with or without ramucirumab as second-line treatment for malignant pleural mesothelioma (RAMES): a randomised, double-blind, placebo-controlled, phase 2 trial — C. Pinto, P.A. Zucali, et al. (2021)

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