Is Radiotherapy Useful for Treating Pain in Mesothelioma?: A Phase II Trial

MacLeod, Nicholas; Chalmers, Anthony J.; O’Rourke, N.; Moore, Karen; Sheridan, Jonathan; McMahon, Lynn; Bray, Caroline; Stobo, Jon; Price, A.; Fallon, Marie; Laird, Barry

doi:10.1097/jto.0000000000000499

Cited by 74 publications

(43 citation statements)

References 13 publications

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“…In the palliative setting, radiotherapy can reduce tumour bulk and relieve symptoms, particularly in the context of chest wall invasion, nerve root involvement or painful cutaneous metastases. The prospective phase II SYSTEMS trial showed that a dose of 20 gy, delivered in five daily fractions, reduced patient-reported pain scores by ⩾30% in 14 (35%) out of 40 participants [92]. Further trials evaluating the optimum radiotherapy dose and choice of regimen are underway.…”

Section: Radiotherapymentioning

confidence: 99%

Malignant pleural mesothelioma: an update on investigation, diagnosis and treatment

et al. 2016

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Malignant pleural mesothelioma is an aggressive malignancy of the pleural surface, predominantly caused by prior asbestos exposure. There is a global epidemic of malignant pleural mesothelioma underway, and incidence rates are predicted to peak in the next few years.This article summarises the epidemiology and pathogenesis of malignant pleural mesothelioma, before describing some key factors in the patient experience and outlining common symptoms. Diagnostic approaches are reviewed, including imaging techniques and the role of various biomarkers. Treatment options are summarised, including the importance of palliative care and methods of controlling pleural effusions. The evidence for chemotherapy, radiotherapy and surgery is reviewed, both in the palliative setting and in the context of trimodality treatment. An algorithm for managing malignant pleural effusion in malignant pleural mesothelioma patients is presented. Finally new treatment developments and novel therapeutic approaches are summarised.

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Section: Radiotherapymentioning

confidence: 99%

Malignant pleural mesothelioma: an update on investigation, diagnosis and treatment

et al. 2016

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“…For decades, palliative RT has been routinely offered for MPM pain, despite widely varying response rates (0-69%) and an inconclusive systematic review in 2014 [58]. In 2016, the SYSTEMS study, a multicentre, single-arm, phase II study reported an improvement in pain in only 35% of patients following 20Gy/5♯ [59], which is the standard dose in most centres. SYSTEMS-2, a randomised Phase III study is currently recruiting, comparing dose escalation (to 36Gy/6♯) to 20Gy/ 5♯, for which there is now robust efficacy data based on the results of the original SYSTEMS study.…”

Section: Radiotherapymentioning

confidence: 99%

Progress and challenges in Mesothelioma: From bench to bedside

Blyth

Murphy

2018

Respiratory Medicine

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Malignant Pleural Mesothelioma (MPM) is currently an incurable cancer with a typical survival of 1 year from the time of diagnosis. The recent genomic and transcriptomic characterization of MPM presents new opportunities and challenges for MPM researchers. Recent advances in clinical and laboratory diagnostics, and proposals for an updated, data-driven, staging system, also present new challenges for clinicians and hospital services involved in MPM care. The aim of this review is first to introduce the reader to the topic of MPM, a disease that is causally linked to prior, typically occupational, exposure to asbestos fibres. Secondly, we will discuss MPM from the clinical and laboratory perspectives, including reviews of current and evolving therapies and our present understanding of the molecular basis of the disease. Finally, we will attempt to identify critical knowledge gaps that currently prevent more effective treatment, including the challenges involved in early detection and chemoprophylaxis.

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“…94 In 2015, the Symptom Study of Radiotherapy in Mesothelioma (SYSTEMS-1) phase 2 trial reported that at week 5, 47% of surviving patients receiving RT at a dose of 20 Gy in five daily fractions experienced symptom improvement. 95 The authors concluded that RT for pain control in MPM is effective in some patients and plan to follow up their study with SYSTEMS-2, which will compare standard palliative RT dosing at 20 Gy in five daily fractions to an escalated dosing of 36 Gy in six daily fractions. 96…”

Section: Radiation Therapymentioning

confidence: 99%

Malignant Mesothelioma: Has Anything Changed?

Kim

Sterman

Haas

2019

Semin Respir Crit Care Med

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Malignant pleural mesothelioma is a rare cancer associated with asbestos exposure and portends a dismal prognosis. Its worldwide incidence has been increasing, and treatment options are currently suboptimal and noncurative. However, since the turn of the century, several encouraging steps have been made toward improving outcomes for mesothelioma patients. An increased understanding of disease pathophysiology has led to more accurate diagnosis and staging, and the establishment of the standard of care first-line pemetrexed/platin doublet chemotherapy regimen in 2003 initially revolutionized treatment. While significant debate remains regarding the preferred approach to surgical and radiation therapy in the context of multimodal therapy, recent breakthroughs in immunotherapy offer hope for another paradigm shift in the near future. This review will summarize the current clinical approach to diagnosis, staging, and treatment of malignant pleural mesothelioma.

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Is Radiotherapy Useful for Treating Pain in Mesothelioma?: A Phase II Trial

Abstract: Radiotherapy for pain control in MPM is an effective treatment in a proportion of patients. Future studies examining differing radiotherapy regimens with a view to improving response rates are warranted.

Cited by 74 publications

References 13 publications

Malignant pleural mesothelioma: an update on investigation, diagnosis and treatment

Malignant pleural mesothelioma: an update on investigation, diagnosis and treatment

Progress and challenges in Mesothelioma: From bench to bedside

Malignant Mesothelioma: Has Anything Changed?

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