Management of malignant pleural mesothelioma-part 2: therapeutic approaches : Consensus of the Austrian Mesothelioma Interest Group (AMIG)

Mir Alireza Hoda, Thomas Klikovits, Madeleine Arns, Karin Dieckmann, Sabine Zöchbauer-Müller, Christian Geltner, Bernhard Baumgartner, Peter Errhalt, Barbara Machan, Wolfgang Pohl, Jörg Hutter, Josef Eckmayr, Michael Studnicka, Martin Flicker, Peter Cerkl, Walter Klepetko

Research output: Journal article (peer-reviewed)Journal article

Abstract

Treatment of malignant pleural mesothelioma (MPM) depends on performance status of the patient, tumor stage, and histological differentiation. Chemotherapy (CHT) can be administered as first- and second-line treatment in unresectable MPM or as neoadjuvant or adjuvant treatment before or after surgery. A combination of an antifolate and platinum-based CHT is the only approved standard of care. Several targeted and immunotherapies are in evaluation and further studies are warranted to determine the therapeutic value of these new treatment options. Radiotherapy (RT) can be considered either as adjuvant treatment after surgery or for palliation of pain-related tumor growth. Recent data support the use of RT in a neoadjuvant setting. Macroscopic complete resection by pleurectomy/decortication (P/D) or extrapleural pneumonectomy (EPP) is indicated in selected patients with good performance status. Surgery should only be applied as part of a multimodality treatment (MMT) in combination with chemo- and/or radiotherapy. In a large number of cases, palliative attempts are needed to improve quality of life and to achieve symptom control.

Original languageEnglish
Pages (from-to)618-626
Number of pages9
JournalWiener Klinische Wochenschrift
Volume128
Issue number17-18
DOIs
Publication statusPublished - 1 Sep 2016

Keywords

  • Austria
  • Chemoradiotherapy/standards
  • Diagnosis, Differential
  • Evidence-Based Medicine/standards
  • Humans
  • Medical Oncology/standards
  • Mesothelioma/diagnosis
  • Pleural Effusion, Malignant/therapy
  • Pleural Neoplasms/therapy
  • Practice Guidelines as Topic
  • Thoracic Surgical Procedures/standards
  • Treatment Outcome

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