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Study Shows Pleural Mesothelioma Patients Live Longer With Trimodal Therapy

Pleural Mesothelioma Patient - Trimodal Therapy

One of the biggest challenges in pleural mesothelioma care is determining which treatments to use on patients.

Oncologists are faced with deciding if a patient will benefit from surgery, chemotherapy or radiation, or a combination of the three.

Although each case is different, when mesothelioma patients are candidates for all of the options, which approach is the best?

Researchers report the results of a recent in-depth review of thousands of mesothelioma patient records points to the best survival when all three therapies are used.

A team of researchers from The University of Texas MD Anderson Cancer Center selected 20,561 malignant pleural mesothelioma (MPM) patient records, from the National Cancer Database for the years from 2004 to 2014, to evaluate patient survival. Noting that MPM is an “aggressive and rapidly fatal disease,” the team set out to determine the key predictors of mesothelioma patient survival.

Specifically, the team wanted to assess the difference in patients who first had mesothelioma surgery, then went on to have chemotherapy and/or radiation versus patients who did not have surgery.

The team narrowed the number of patients evaluated down to 6,645 from the initial selection and compared the results of patients with the following breakdown of treatment approaches:

  • 2,166 underwent no therapy
  • 2,015 underwent chemotherapy alone
  • 850 underwent cancer-directed surgery alone
  • 988 underwent surgery with chemotherapy
  • 274 underwent trimodality therapy

The remaining 352 patients underwent another combination of surgery, radiation, or chemotherapy.

Although the researchers found that while any of the treatments alone were associated with improved survival, when chemotherapy and radiation followed cancer-directed surgery the” largest estimated effect was realized.”

Most importantly, patients diagnosed with epithelioid mesothelioma, the most common and treatable histological subtype of mesothelioma diagnosed in more than half of all mesothelioma cases, who received trimodal care had a median survival of 23.4 months vs. 14.5 months.

The team concluded that for mesothelioma patients, “Surgery-based multimodality therapy was associated with improved survival and may offer therapeutic benefit among carefully selected patients.”

MD Anderson’s Mesothelioma Program is comprised of a team of more than 30 experts representing medical oncologists, surgeons, radiation oncologists, pulmonologists and pathologists who work closely together to customize the best treatment for each patient.

Everyone on the team is considered an expert in their field and in mesothelioma. The Center cares for more patients with mesothelioma than almost any other center in the U.S., according to its website.

Read the full study in the Aug. 17 issue of Journal Of Clinical Oncology.

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