Trends and challenges in treatment of malignant pleural mesothelioma

Our plain-English summary of Trends and challenges in treatment of malignant pleural mesothelioma, by A. Tsiouris, A. Kourliouros, E.J. Smith (British Journal of Hospital Medicine, 2009).

The study

• Authors: A. Tsiouris, A. Kourliouros, E.J. Smith
• Journal: British Journal of Hospital Medicine
• Published: 2009;70(6):312-3
• Type of article: Editorial
• Read it: PubMed · Publisher

In plain English

This was an editorial, not a study. The authors collected no new patient data. They gave an overview of how malignant pleural mesothelioma is diagnosed and treated, citing earlier published work. They described the disease as a locally invasive carcinoma of the pleura and stated that 80 per cent of patients have a history of asbestos exposure, sometimes many years earlier. They wrote that annual mesothelioma deaths in the UK rose from 153 in 1968 to 2037 in 2005, and that mean survival without treatment ranges from 4 to 12 months. They described surgery, radiotherapy and chemotherapy, used alone or in combination. The authors concluded that combining treatments is the cornerstone of care, that surgery should be the first-line treatment when the tumour can be removed, and that platinum compounds and pemetrexed are the most effective drugs. They also concluded that radical radiation alone should not be offered as a cure. They noted that no randomized trials have compared treatment regimens, so the best combination is not yet known. They questioned whether UK lung cancer teams, which discuss an estimated 90 per cent of cases, give mesothelioma enough time.

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 diagnosis and treatment, citing earlier published work; no new data)
• Who was studied: No patients or groups were studied; the editorial discussed patients with malignant pleural mesothelioma in general, with reference to the UK
• Exposure: Asbestos in general; the editorial described how chrysotile and amphibole fibres are inhaled and reach the pleura, but studied no specific exposure
• Main results:
  • The editorial stated that 80 per cent of patients with malignant pleural mesothelioma have a history of asbestos exposure, in some cases many years ago (background statement, not a finding of this article)
  • The editorial stated that annual mesothelioma deaths in the UK increased from 153 in 1968 to 2037 in 2005 (background statement, not a finding of this article)
  • The editorial stated that mean survival without treatment ranges from 4 to 12 months
  • The authors stated that an estimated 90% of malignant pleural mesothelioma cases in the UK are discussed at lung cancer meetings, citing the Department of Health (2007)
  • The authors' view was that platinum compounds and pemetrexed, alone or as part of a three-treatment regimen, can stabilize symptoms and offer survival benefit
• The authors' conclusion: The authors concluded that a multimodality approach is the cornerstone of treatment and that surgery should be first-line when resection is feasible. They also concluded that early chemotherapy is recommended for tumours that cannot be removed, and that radical radiation alone should not be offered as a curative option.
• Limitations the authors state:
  • The authors noted that no randomized trials have compared different treatment regimens
  • The authors noted that the best combination of treatments has not yet been defined

Topics

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

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

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