Randomized Trials of Systemic Medically-treated
Malignant Mesothelioma
Abstract. Malignant pleural mesothelioma (MPM) is a rare
but aggressive malignancy mainly localized to the pleura.
Malignant mesothelioma grows highly invasive into
surrounding tissue and has a low tendency to metastasize. The
median overall survival (OS) of locally advanced or metastatic
disease without treatment is 4-13 months but, during recent
years, improvement in survival has been achieved since
treatment for patients with mesothelioma has improved with
better palliative care, systemic medical treatment, surgery and
improved diagnostics methods. The present review aims at
describing available data from randomized trials considering
systemic medical treatment for this patient category.
Malignant pleural mesothelioma (MPM) is a rare malignancy
mainly localized to the pleura. It is an aggressive tumor with
poor prognosis. Malignant mesothelioma grows highly
invasive into surrounding tissue although it has a low
tendency to metastasize. The median overall survival (OS) of
locally advanced or metastatic disease without treatment is 4-
13 months (1, 2). Multimodality treatment, including
chemotherapy, surgery and radiation therapy, is an option
only for a small subset of patients and systemic treatment is
the main therapeutic option for most patients. In recent years,
prognosis for patients with mesothelioma has improved with
better palliative care, systemic medical treatment, surgery and
improved diagnostics methods. The present review aims at
describing available randomized trials considering systemic
medical treatment for this patient category.
Materials and Methods
We searched for randomized studies between different systemic
medical treatments or between systemic medical treatments and best
supportive care (BSC). We excluded studies concerning surgery
and/or radiotherapy. We also excluded all non-randomized studies
not written in English and studies where the majority of the patients
did not suffer from mesothelioma.
Studies were identified through a systematic search of Medline
and www.clinicaltrials.gov until October 2014. In addition, all
guidelines and review articles published since 2006 were
systematically searched in their references for further studies.
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