The timing of chemotherapy in the management plan for medically operable early-stage malignant pleural mesothelioma

ABSTRACT

Introduction: Trimodality therapy (including surgery, chemotherapy and radiation therapy) represents an important management approach of early-stage malignant pleural mesothelioma (MPM). The oncological value, as well as the proper sequence of the three modalities, is still under investigations.

Areas Covered: The article covers the timing of chemotherapy in the management plan with either a neoadjuvant approach or adjuvant approach. It evaluates also how to select patients for induction chemotherapy and how to assess the response to treatment.

Expert Opinion: Management of patients with early-stage MPM must be completed in a multidisciplinary team in tertiary centers. Availability of newer prognostic and response assessment tools should facilitate the use of induction chemotherapy as well as the selection of patients who might benefit from radical surgery.

KEYWORDS:

• Mesothelioma
• surgery
• chemotherapy
• timing

Article highlights

• Trimodality therapy (including surgery, chemotherapy and radiation therapy) represents an important management approach of early-stage malignant pleural mesothelioma.

• The oncological value, as well as the proper sequence of the three modalities, is still under investigations.

• This review covers the timing of chemotherapy in the management plan either ‘neoadjuvant approach’ or in the adjuvant setting.

• It evaluates also how to select the patients for induction chemotherapy and how to assess the response to treatment.

• Management of patients with early-stage MPM has to be completed in a multidisciplinary team in tertiary centers.

• Availability of newer prognostic and response assessment tools should facilitate the use of induction chemotherapy as well as the selection of patients who might benefit from radical surgery.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewers Disclosure

Peer reviewers on this manuscript have no relevant financial relationships or otherwise to disclose.

Additional information

Funding

This paper was not funded.