Improvement of Malignant Pleural Mesothelioma Prognosis: Early Diagnosis and Multimodality Treatment

Our plain-English summary of Improvement of Malignant Pleural Mesothelioma Prognosis: Early Diagnosis and Multimodality Treatment, by C.J. Ban, H.Z. Shi, Y.H. Zhang (Chinese Medical Journal, 2017).

The study

• Authors: C.J. Ban, H.Z. Shi, Y.H. Zhang
• Journal: Chinese Medical Journal
• Published: 2017;130(1):1-3
• Type of article: Editorial
• Cited by: 3 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

In plain English

This article is an editorial, not a new study. The authors gave an overview of MPM diagnosis, treatment and prognosis. They described malignant pleural mesothelioma (MPM) as typically related to mineral fibers such as asbestos and erionite. Citing published work, they reported a diagnostic yield of about 80–90% or more for thoracoscopy-guided biopsy in MPM. They also cited two earlier studies by their group. In one, medical thoracoscopy had an overall diagnostic efficiency of 92.6% for pleural effusions of undetermined cause in a Chinese population. In the other, a retrospective study of 30 MPM patients (25 diagnosed by thoracoscopy), 13 survived over 12 months and 9 over 17 months. The editorial also cited a randomized trial in patients with unresectable MPM, performance status 0–2 and no bleeding or thrombosis, in which adding bevacizumab (with maintenance bevacizumab) to cisplatin/pemetrexed increased overall survival. It also covered surgery, radiotherapy and prognostic markers. The authors concluded current therapies have very limited efficacy and prognosis remains quite poor. They suggested early diagnosis, multimodality treatment and new options such as immunotherapy and targeted therapies may be the optimal management.

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: editorial (narrative overview of published studies and guidelines; no new data)
• Who was studied: No study population of its own; the editorial discusses patients with malignant pleural mesothelioma in general, drawing on cited studies
• Exposure: Mentioned as background only: mineral fibers such as asbestos and erionite; no specific fiber types or doses studied
• Main results:
  • Cited from published work: thoracoscopy-guided biopsies have a diagnostic yield of about 80–90% (or more) for MPM
  • Cited from the authors' group's earlier study (reference 9): medical thoracoscopy had an overall diagnostic efficiency of 92.6% for pleural effusions of undetermined causes in a Chinese population
  • Cited from the authors' group's earlier retrospective study (reference 6) of 30 MPM patients, 25 diagnosed through medical thoracoscopy: 43.3% (13/30) survived more than 12 months and 30% (9/30) more than 17 months
  • Cited from the same earlier study (reference 6): pemetrexed with cisplatin or carboplatin, followed by pemetrexed alone, could prolong survival
  • Cited multicenter Phase 3 randomized trial (reference 12): it compared bevacizumab added to cisplatin/pemetrexed, with maintenance bevacizumab, against cisplatin/pemetrexed alone. Patients had unresectable MPM, performance status 0–2, and no bleeding or thrombosis
  • In that trial, overall survival was increased in the bevacizumab plus chemotherapy group compared with chemotherapy alone
  • Cited from another study (reference 16): gemcitabine with vinorelbine achieved 82% disease control in 17 Japanese MPM patients previously treated with platinum plus pemetrexed
  • Surgery figures given by the editorial: 30-day mortality after extrapleural pneumonectomy ranged from 2.2% to 11%, and in-hospital mortality could reach 31%. For pleurectomy/decortication, 30-day mortality ranged from 0% to 11%
• The authors' conclusion: The authors concluded that current therapies for MPM have very limited efficacy and that overall prognosis remains quite poor. They suggested that optimal management may be early diagnosis, multimodality treatment and developing new treatments such as immunotherapy and targeted therapies.

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.

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