Malignant mesothelioma: predictors of prognosis and clinical trials

Our plain-English summary of Malignant mesothelioma: predictors of prognosis and clinical trials, by J.P. Steele, R.M. Rudd (Thorax, 2000).

The study

• Authors: J.P. Steele, R.M. Rudd
• Journal: Thorax
• Published: 2000;55(9):725-6
• Type of article: Comment, Editorial
• Cited by: 14 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Summary of the article

In this editorial, the authors discussed prognosis and clinical trials in malignant mesothelioma, commenting on a study by Edwards et al in the same issue of Thorax. They noted that the incidence of malignant mesothelioma was increasing in the UK and continental Europe and that effective treatment remained elusive. Radical surgery was rarely performed in the UK. Radiotherapy could relieve pain but had no evidence of improving survival. Three recent phase II chemotherapy trials had reported tumour response rates exceeding 20%, with improved symptoms. The authors reviewed staging systems (Butchart, IMIG and Brigham). They argued that prognostic scoring systems were the most practical way to assess prognosis for most patients and to stratify patients in randomised trials. They summarised Edwards et al's retrospective analysis of patients treated at a single institution in Leicester between 1988 and 1999. That analysis found that the EORTC and CALGB scoring systems both correctly identified patients with a poor prognosis. On multivariate analysis, poor prognostic factors were sarcomatous cell type, low haemoglobin, high white blood cell count, poor performance status and male sex. One and two year survival rates were 21.3% and 3.5%. The authors concluded that these systems could be considered for prospective use in forthcoming phase II and III trials. They also described a planned British Thoracic Society and Medical Research Council three arm phase III trial comparing vinorelbine, MVP chemotherapy and best supportive care.

PubMed has no abstract for this study, and the article doesn't print one. We wrote this summary from the full article with the help of AI. It is not the authors' wording.

In plain English

This article was a two-page editorial, not an original study. The authors commented on a paper by Edwards et al in the same issue of Thorax. As the editorial described it, Edwards et al retrospectively analysed patients with mesothelioma treated at a single institution in Leicester between 1988 and 1999. Edwards et al tested two existing prognostic scoring systems, from the European Organization for Research and Treatment of Cancer (EORTC) and the US Cancer and Leukemia Group B (CALGB). According to the editorial, both systems correctly identified Leicester patients with a poor prognosis. In that series, poor prognosis was linked to sarcomatous cell type, low haemoglobin, high white blood cell count, poor performance status and male sex. One year and two year survival rates were 21.3% and 3.5%. The authors also noted that three recent phase II chemotherapy trials had reported tumour response rates exceeding 20%. They concluded that clinical trials should stratify patients by prognostic group, and that the EORTC and CALGB systems could be considered for prospective use in forthcoming phase II and III trials. The editorial did not discuss asbestos exposure.

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 commenting on another study (Edwards et al, Thorax 2000) published in the same issue; no original data
• Who was studied: No population of its own. It discussed Edwards et al's retrospective analysis of patients with mesothelioma treated at a single institution in Leicester, UK, between 1988 and 1999.
• Main results:
  • As reported by the editorial for Edwards et al's Leicester series, both the EORTC and CALGB scoring systems correctly identified patients with a poor prognosis.
  • As reported by the editorial, the poor-prognosis factors in multivariate analysis of the Leicester patients were sarcomatous cell type, low haemoglobin, high white blood cell count, poor performance status and male sex.
  • As reported by the editorial, one year and two year survival rates for the Leicester patients were 21.3% and 3.5%.
  • As reported by the editorial, survival rates for Leicester patients within each prognostic group were equivalent to those of patients in the EORTC and CALGB series.
  • As background, the editorial stated that three recent phase II chemotherapy trials (other studies) had reported tumour response rates exceeding 20%.
• The authors' conclusion: The authors concluded that clinical trials should stratify patients according to prognostic group, and that the EORTC and CALGB systems could be considered for prospective use in forthcoming phase II and III trials in malignant mesothelioma.

Topics

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

Medical terms in this study, explained in our Lexicon: Mesothelioma, Prognosis, Clinical Trial, Thorax, Chemotherapy, Staging, IMIG, Multivariate Analysis.

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