The Challenge of Defining Treatment Standards for a Rare Disease: Malignant Peritoneal Mesothelioma

Our plain-English summary of The Challenge of Defining Treatment Standards for a Rare Disease: Malignant Peritoneal Mesothelioma, by H.L. Kindler (Journal of Oncology Practice, 2016).

The study

• Author: H.L. Kindler
• Journal: Journal of Oncology Practice
• Published: 2016;12(10):936-937
• Type of article: Comment
• Cited by: 2 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

In plain English

This is a short commentary, not a research study. It accompanied an article by Sugarbaker and colleagues on treating malignant peritoneal mesothelioma and reports no new data. The commentary does not discuss asbestos exposure. The author noted that only 10.5% of mesotheliomas in the SEER database from 1973 to 2005 started in the peritoneum. The author wrote that treatment standards come mostly from small studies looking back at past cases, and that forward-looking trials are infrequent, small and nonrandomized. Citing other studies, the author described a 5-year survival approaching 50% with cytoreductive surgery combined with heated chemotherapy delivered inside the abdomen. The author added that more than 60% of patients still do not undergo cytoreduction. The author said the role of drug treatment given throughout the body is unclear in patients whose disease can be surgically removed. The author described one earlier study of 126 patients as hypothesis generating. The author concluded that routinely using this combined surgery and chemotherapy at highly experienced centers is likely to improve survival. The author added that further progress will only come through international collaboration and prospective clinical trials.

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: Commentary (opinion piece accompanying another article); no original data
• Who was studied: No study population; the commentary discusses the treatment of patients with malignant peritoneal mesothelioma in general
• Main results:
  • The author cites the SEER database (another source): only 10.5% of mesotheliomas identified from 1973 to 2005 originated in the peritoneum
  • The author states that prospective trials in peritoneal mesothelioma are infrequent, small and nonrandomized
  • Citing other studies, the author reports a 5-year survival approaching 50% with cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy, compared with historical controls
  • Citing another study, the author states that more than 60% of patients with peritoneal mesothelioma still do not undergo cytoreduction
  • The author states that the role of systemic therapy in patients with resectable disease is unclear, and that pemetrexed is the only US Food and Drug Administration approved drug
  • The author describes another group's retrospective study of 126 patients at 20 tertiary centers from 1991 to 2014. Those investigators concluded that adjuvant chemotherapy may delay recurrence and neoadjuvant chemotherapy might be harmful. The author calls that study hypothesis generating.
• The authors' conclusion: The author concluded that routine use of cytoreductive surgery with hyperthermic intraperitoneal chemotherapy at highly experienced centers is likely to improve survival, but that further progress requires international collaboration and prospective clinical trials

Topics

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

Medical terms in this study, explained in our Lexicon: Peritoneal Mesothelioma.

Related studies

• Malignant peritoneal mesothelioma in a 16-year-old girl: presentation of a rare disease — I.B. Brecht, A. Agaimy, et al. (2012)
• The IASLC Mesothelioma Staging Project: Improving Staging of a Rare Disease Through International Participation — H. Pass, D. Giroux, et al. (2016)
• Primary pericardial mesothelioma and asbestos exposure: a rare fatal disease — D.M.M. Freitas, R.L. Ramos, et al. (2017)
• Rare pleural tumors — C.T. Erb, K.M. Johnson, et al. (2013)
• Multicystic peritoneal mesothelioma: A short review — C.H. Zhang, J.W. Yu, et al. (2017)
• First case report of malignant peritoneal mesothelioma and oral verrucous carcinoma in a patient with a germline PTEN mutation: a combination of extremely rare diseases with probable further implications — M.W. Löffler, J. Steinhilber, et al. (2018)

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