Treatment of Malignant Pleural Mesothelioma: American Society of Clinical Oncology Clinical Practice Guideline

Overview

Journal J Clin Oncol

Specialty Oncology

Date 2018 Jan 19

PMID 29346042

Citations 154

Authors

Hedy L Kindler

Nofisat Ismaila

Samuel G Armato 3rd

Raphael Bueno

Mary Hesdorffer

Thierry Jahan

Clyde Michael Jones

Markku Miettinen

Harvey Pass

Andreas Rimner

Valerie Rusch

Daniel Sterman

Anish Thomas

Raffit Hassan

Affiliations

Soon will be listed here.

Abstract

Purpose To provide evidence-based recommendations to practicing physicians and others on the management of malignant pleural mesothelioma. Methods ASCO convened an Expert Panel of medical oncology, thoracic surgery, radiation oncology, pulmonary, pathology, imaging, and advocacy experts to conduct a literature search, which included systematic reviews, meta-analyses, randomized controlled trials, and prospective and retrospective comparative observational studies published from 1990 through 2017. Outcomes of interest included survival, disease-free or recurrence-free survival, and quality of life. Expert Panel members used available evidence and informal consensus to develop evidence-based guideline recommendations. Results The literature search identified 222 relevant studies to inform the evidence base for this guideline. Recommendations Evidence-based recommendations were developed for diagnosis, staging, chemotherapy, surgical cytoreduction, radiation therapy, and multimodality therapy in patients with malignant pleural mesothelioma. Additional information is available at www.asco.org/thoracic-cancer-guidelines and www.asco.org/guidelineswiki .

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References

Muers M, Stephens R, Fisher P, Darlison L, Higgs C, Lowry E . Active symptom control with or without chemotherapy in the treatment of patients with malignant pleural mesothelioma (MS01): a multicentre randomised trial. Lancet. 2008; 371(9625):1685-94. PMC: 2431123. DOI: 10.1016/S0140-6736(08)60727-8. View

Meyerhoff R, Yang C, Speicher P, Gulack B, Hartwig M, DAmico T . Impact of mesothelioma histologic subtype on outcomes in the Surveillance, Epidemiology, and End Results database. J Surg Res. 2015; 196(1):23-32. PMC: 4430361. DOI: 10.1016/j.jss.2015.01.043. View

Chance W, Rice D, Allen P, Tsao A, Fontanilla H, Liao Z . Hemithoracic intensity modulated radiation therapy after pleurectomy/decortication for malignant pleural mesothelioma: toxicity, patterns of failure, and a matched survival analysis. Int J Radiat Oncol Biol Phys. 2014; 91(1):149-56. DOI: 10.1016/j.ijrobp.2014.08.343. View

Grigoriu B, Chahine B, Vachani A, Gey T, Conti M, Sterman D . Kinetics of soluble mesothelin in patients with malignant pleural mesothelioma during treatment. Am J Respir Crit Care Med. 2009; 179(10):950-4. DOI: 10.1164/rccm.200807-1125OC. View

Infante M, Morenghi E, Bottoni E, Zucali P, Rahal D, Morlacchi A . Comorbidity, postoperative morbidity and survival in patients undergoing radical surgery for malignant pleural mesothelioma. Eur J Cardiothorac Surg. 2016; 50(6):1077-1082. DOI: 10.1093/ejcts/ezw215. View

Alvarez J, Hasani A, Segal A, Sterret G, Millward M, Nowak A . Bilateral thoracoscopy, mediastinoscopy and laparoscopy, in addition to CT, MRI and PET imaging, are essential to correctly stage and treat patients with mesothelioma prior to trimodality therapy. ANZ J Surg. 2009; 79(10):734-8. DOI: 10.1111/j.1445-2197.2009.05060.x. View

Pan H, Jiang S, Sutton J, Liao Z, Chance W, Frank S . Early experience with intensity modulated proton therapy for lung-intact mesothelioma: A case series. Pract Radiat Oncol. 2015; 5(4):e345-53. DOI: 10.1016/j.prro.2014.11.005. View

Krayenbuehl J, Dimmerling P, Ciernik I, Riesterer O . Clinical outcome of postoperative highly conformal versus 3D conformal radiotherapy in patients with malignant pleural mesothelioma. Radiat Oncol. 2014; 9:32. PMC: 3946177. DOI: 10.1186/1748-717X-9-32. View

Boutin C, Rey F . Thoracoscopy in pleural malignant mesothelioma: a prospective study of 188 consecutive patients. Part 1: Diagnosis. Cancer. 1993; 72(2):389-93. DOI: 10.1002/1097-0142(19930715)72:2<389::aid-cncr2820720213>3.0.co;2-v. View

10.

Sharkey A, OByrne K, Nakas A, Tenconi S, Fennell D, Waller D . How does the timing of chemotherapy affect outcome following radical surgery for malignant pleural mesothelioma?. Lung Cancer. 2016; 100:5-13. DOI: 10.1016/j.lungcan.2016.07.023. View

11.

Santoro A, OBrien M, Stahel R, Nackaerts K, Baas P, Karthaus M . Pemetrexed plus cisplatin or pemetrexed plus carboplatin for chemonaïve patients with malignant pleural mesothelioma: results of the International Expanded Access Program. J Thorac Oncol. 2008; 3(7):756-63. DOI: 10.1097/JTO.0b013e31817c73d6. View

12.

Metintas M, Ak G, Erginel S, Alatas F, Yildirim H, Kurt E . A retrospective analysis of malignant pleural mesothelioma patients treated either with chemotherapy or best supportive care between 1990 and 2005 A single institution experience. Lung Cancer. 2006; 55(3):379-87. DOI: 10.1016/j.lungcan.2006.11.005. View

13.

Gomez D, Hong D, Allen P, Welsh J, Mehran R, Tsao A . Patterns of failure, toxicity, and survival after extrapleural pneumonectomy and hemithoracic intensity-modulated radiation therapy for malignant pleural mesothelioma. J Thorac Oncol. 2012; 8(2):238-45. PMC: 5610569. DOI: 10.1097/JTO.0b013e31827740f0. View

14.

Armato 3rd S, Oxnard G, MacMahon H, Vogelzang N, Kindler H, Kocherginsky M . Measurement of mesothelioma on thoracic CT scans: a comparison of manual and computer-assisted techniques. Med Phys. 2004; 31(5):1105-15. DOI: 10.1118/1.1688211. View

15.

Rusch V, Piantadosi S, Holmes E . The role of extrapleural pneumonectomy in malignant pleural mesothelioma. A Lung Cancer Study Group trial. J Thorac Cardiovasc Surg. 1991; 102(1):1-9. View

16.

Opitz I, Friess M, Kestenholz P, Schneiter D, Frauenfelder T, Nguyen-Kim T . A New Prognostic Score Supporting Treatment Allocation for Multimodality Therapy for Malignant Pleural Mesothelioma: A Review of 12 Years' Experience. J Thorac Oncol. 2015; 10(11):1634-41. DOI: 10.1097/JTO.0000000000000661. View

17.

Krayenbuehl J, Oertel S, Bernard Davis J, Ciernik I . Combined photon and electron three-dimensional conformal versus intensity-modulated radiotherapy with integrated boost for adjuvant treatment of malignant pleural mesothelioma after pleuropneumonectomy. Int J Radiat Oncol Biol Phys. 2007; 69(5):1593-9. DOI: 10.1016/j.ijrobp.2007.07.2370. View

18.

Thomas R, Budgeon C, Kuok Y, Read C, Fysh E, Bydder S . Catheter tract metastasis associated with indwelling pleural catheters. Chest. 2014; 146(3):557-562. DOI: 10.1378/chest.13-3057. View

19.

Weder W, Opitz I . Multimodality therapy for malignant pleural mesothelioma. Ann Cardiothorac Surg. 2013; 1(4):502-7. PMC: 3741801. DOI: 10.3978/j.issn.2225-319X.2012.11.12. View

20.

Arrieta O, Lopez-Macias D, Mendoza-Garcia V, Bacon-Fonseca L, Munoz-Montano W, Macedo-Perez E . A phase II trial of prolonged, continuous infusion of low-dose gemcitabine plus cisplatin in patients with advanced malignant pleural mesothelioma. Cancer Chemother Pharmacol. 2014; 73(5):975-82. DOI: 10.1007/s00280-014-2429-5. View