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Pleural mesothelioma: tackling a deadly cancer

February 11, 2019 By Thomas Lamb

A new study from the University of Pittsburgh has highlighted six factors that are associated with improved survival in patients with mesothelioma; age under 45 years, female, epithelioid histological subtype, peritoneal mesothelioma, stage 1 cancer, and being treated with both surgery and chemotherapy. This knowledge, together with recent reports showing promising findings from the use of new targeted immunotherapy agents in malignant pleural mesothelioma, provides new hope for this rare and deadly cancer.

Mesothelioma is usually caused by exposure to asbestos, and predominantly affects the lining of the lungs—so-called pleural mesothelioma. Patients with pleural mesothelioma have a poor median survival from diagnosis of around 1 year. A report from the International Agency for Research on Cancer indicates that the disease burden is still substantial with 30,443 cases of malignant mesothelioma, and 25,576 deaths worldwide, according to GLOBOCAN 2018 statistics. Identification of patients with a good prognosis is key to appropriate management. The Pittsburgh researchers used the National Mesothelioma Virtual Bank, a US collection of de-identified biospecimens, to assess survival according to clinical factors. They assessed 888 patients diagnosed between 1990 and 2017 to identify the six factors associated with a better survival. Such analyses can provide guidance on those patients who might respond best to treatment as well as indicate stratification factors for future trials.

Surgery is a possible option for patients; however, it can be both challenging and associated with subsequent morbidity. Furthermore, not all patients are eligible for surgery, depending on their overall fitness and the type and site of the cancer. There is currently only one FDA-approved first-line treatment; a platinum-based doublet and pemetrexed….

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