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American Society of Clinical Oncology Updates Treatment Recommendations for Pleural Mesothelioma Treatment

The American Society of Clinical Oncology (ASCO) recently convened an expert panel of doctors, researchers, and cancer advocacy experts to review medical literature on mesothelioma studies conducted from 1990 to 2017. The expert panel did so with special interest to survival, disease-free or recurrence-free survival, and quality of life using available evidence and informal consensus to develop evidence-based guideline recommendations on how best to treat pleural mesothelioma.


Pleural mesothelioma is a rare form of lung cancer caused by exposure to asbestos, a naturally occurring mineral once commonly used in a variety of industrial and commercial applications for its heat resistant properties. Mesothelioma can take decades to show symptoms and unfortunately, there is no cure for the cancer that can spread from the thin linings of tissue surrounding the lungs to other vital organs.


The expert panel identified a total of 222 studies from the 27-year time period and developed several evidence-based recommendations developed for diagnosis, staging, chemotherapy, surgical cytoreduction, radiation therapy, and multimodality therapy in patients with malignant pleural mesothelioma. The expert panel used five guiding questions to help come up with their recommendations, including:


      What is the optimal approach to obtain an accurate diagnosis of mesothelioma?

      What initial assessment is recommended before initiating any therapy for mesothelioma?

      What is the appropriate first and second-line systemic treatment of patients with mesothelioma?

      What is the appropriate role of surgical cytoreduction in the management of mesothelioma?

      When should radiation be recommended for mesothelioma?


The Expert Panel ultimately concluded that only incremental changes were warranted to the current approach oncologists take to combat the disease. While there have been numerous advances in mesothelioma treatment, the Food and Drug Administration has not approved a new treatment for the disease since 2004.


Using what is called multimodal therapy, the panel recommended that doctors remain committed to a combination of tumor-removing surgery, chemotherapy and radiation therapy. In cases i n whichpatients may not be eligible for surgery, the expert panel recommended chemotherapy or palliative treatment to help ease symptoms.


When a surgical approach is warranted, the expert panel recommended pleurectomy and decortication should be the primary choice over the more invasive option of extrapleural pneumonectomy (EPP) due to the latter having a higher risk of complications for patients. In cases in which surgery is not an option, the expert panel recommended that oncologists add bevacizumab (Avastin) to the combination of chemotherapy drugs, so long as there is no risk of dangerous side effects for the patient. Furthermore, the expert panel recommended that only an experienced mesothelioma specialist apply radiation treatment due to the risks posed to patients.


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If you or a loved one were diagnosed with mesothelioma, contact our office to speak to one of our experienced nationwide mesothelioma attorneys about your situation. Our office can help investigate your case and determine if compensation can be sought from negligent parties to help pay for your medical treatment to help you and your family live a more comfortable life.

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