Medical and oncological management of malignant mesothelioma

Our plain-English summary of Medical and oncological management of malignant mesothelioma, by A.C. Bibby, L. Gibbs, J.P. Braybrooke (British Journal of Hospital Medicine, 2015).

The study

• Authors: A.C. Bibby, L. Gibbs, J.P. Braybrooke
• Journal: British Journal of Hospital Medicine
• Published: 2015;76(7):384-9
• Type of article: Review
• Cited by: 4 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Mesothelioma is an aggressive cancer, for which no curative oncological treatment currently exists. This article outlines the options for managing malignant pleural effusions, describes the developments in chemotherapy over the past 10 years and summarizes the evidence for prophylactic and palliative radiotherapy.

In plain English

This article was a narrative review of medical and oncological treatment for malignant mesothelioma. It reported no new research and did not discuss asbestos exposure. The authors summarized earlier studies. They reported that the TIME2 trial (Davies et al, 2012) found that indwelling pleural catheters and chest drains with talc pleurodesis both relieved breathlessness and chest pain in patients with malignant pleural effusions, with no significant differences between the two methods. In the trial by Vogelzang et al (2003) of 448 patients, median survival was 12.2 months with pemetrexed plus cisplatin, compared with 9.3 months with cisplatin alone. The authors described trial data on preventive radiotherapy to procedure sites as contradictory. Boutin et al (1995) reported that none of 20 patients given radiotherapy developed subcutaneous metastases, compared with 40% in the placebo arm. O'Rourke et al (2007) found no difference in tract seeding. A systematic review (Macleod et al, 2013) found that pain improved in 0% to 69% of patients given palliative radiotherapy. The authors concluded that mesothelioma management options had increased over the past decade.

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 treatment options (pleural fluid control, chemotherapy, radiotherapy, novel agents) for malignant mesothelioma
• Who was studied: No study population of its own; the review concerns patients with malignant mesothelioma, mostly pleural, as studied in earlier trials
• Main results:
  • Reported from the TIME2 trial (Davies et al, 2012): indwelling pleural catheters and chest tube drainage with talc pleurodesis both relieved breathlessness and chest pain in patients with malignant pleural effusions, with no significant differences between the two methods
  • Reported from Vogelzang et al (2003), 448 patients randomized: median survival was 12.2 months in the pemetrexed plus cisplatin group vs 9.3 months in the cisplatin-alone group (P=0.02)
  • Reported from van Meerbeeck et al (2005), 250 patients randomized: median survival was 11.4 months with raltitrexed plus cisplatin vs 8.8 months with cisplatin alone
  • Reported from Boutin et al (1995), 40 patients randomized after chest wall procedures: none of the 20 patients given radiotherapy developed subcutaneous metastases, compared with 40% in the placebo arm (P<0.001)
  • Reported from O'Rourke et al (2007): no difference in tract seeding among 56 patients randomized to prophylactic radiotherapy or best supportive care
  • Reported from a systematic review of eight articles (Macleod et al, 2013): pain improved in 0% to 69% of patients after palliative radiotherapy
• The authors' conclusion: The authors concluded that mesothelioma has no current curative medical treatment, but that management options have increased over the past decade and further developments are anticipated

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: Mesothelioma, Pleural Effusion, Chemotherapy, Palliative Care.

Related studies

• Outcomes and complications following medical thoracoscopy — F.J. Brims, M. Arif, et al. (2012)
• Multicenter randomized controlled trial of the management of unresectable malignant mesothelioma proposed by the British Thoracic Society and the British Medical Research Council — D.J. Girling, M.F. Muers, et al. (2002)
• Catamenial Haemorrhagic Pleural Effusion Caused by Thoracic Endometriosis, which was Controlled by Surgery Undertaken after Failed Medical Management — M.F.K. Hassanein, V. Herminie, et al. (2024)
• Current controversies in the management of malignant pleural effusions — M. Azzopardi, J.M. Porcel, et al. (2014)
• The use of indwelling pleural catheters for the management of malignant pleural effusion--direct costs in a Dutch hospital — R.C. Boshuizen, S. Onderwater, et al. (2013)
• Multicentric initial experience with the use of the pressurized intraperitoneal aerosol chemotherapy (PIPAC) in the management of unresectable peritoneal carcinomatosis — M. Alyami, J. Gagniere, et al. (2017)

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