Pleural Mesothelioma Advances in the Treatment of Malignant

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gemcitabine treatment for malignant mesothelioma: a phase II. study [abstract]. … treatment programs for malignant pleural mesothelioma using …

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DOI 10.1378/chest.116.2.504
Chest 1999;116;504-520
Daniel H. Sterman, Larry R. Kaiser and Steven M. Albelda
Pleural Mesothelioma
Advances in the Treatment of Malignant
http://chestjournal.org/cgi/content/abstract/116/2/504
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Downloaded from chestjournal.org on November 5, 2007Advances in the Treatment of Malignant
Pleural Mesothelioma*
Daniel H. Sterman, MD; Larry R. Kaiser, MD, FCCP; and
Steven M. Albelda, MD
Malignant pleural mesothelioma is a neoplasm that is commonly fatal and for which there are no
widely accepted curative approaches. Mesothelioma is unresponsive to most chemotherapy and
radiotherapy regimens, and it typically recurs even after the most aggressive attempts at surgical
resection. Multimodality approaches have been of some benefit in prolonging survival of very
highly selected subgroups of patients, but they have had a relatively small impact on the majority
of the patients diagnosed with this disease. As the incidence of pleural mesothelioma peaks in the
United States and Europe over the next 10 to 20 years, new therapeutic measures will be
necessary. This review will discuss the roles of chemotherapy, radiotherapy, surgery, and
combined modality approaches in the treatment of pleural mesothelioma, as well as scientific
advances made in the past decade that have led to the development of experimental techniques,
such as photodynamic therapy, immunotherapy, and gene therapy, that are currently undergoing
human clinical trials. These promising new avenues may modify the therapeutic nihilism that is
rampant among clinicians dealing with mesothelioma. (CHEST 1999; 116:…