Radiotherapy for the treatment of malignant pleural mesothelioma

Perrot, Marc de; Wu, Licun; Wu, Mike; Cho, B C John

doi:10.1016/s1470-2045(17)30459-x

Cited by 54 publications

(46 citation statements)

References 98 publications

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“…Research in mice demonstrated that nonablative, hypofractionated radiation induces a specific activation of the immune system against mesothelioma with the development of an in situ vaccination, which is maintained through memory T cells directed against the tumor . Evidence from these mouse experiments and from palliative radiation in patients with mesothelioma suggest that a dose of radiation lower than 25 Gy in 5 fractions to the whole hemithorax may still be effective and limit the risks of pneumonitis in the underlying lung . Indeed, in contrast to normally fractionated radiation, hypofractionated radiation exerts its effect on the tumor through immune activation that is not dose‐dependent.…”

Section: Treatmentmentioning

confidence: 99%

Mesothelioma: Scientific clues for prevention, diagnosis, and therapy

Carbone

Adusumilli

Alexander

et al. 2019

CA A Cancer J Clinicians

334

454

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Mesothelioma affects mostly older individuals who have been occupationally exposed to asbestos. The global mesothelioma incidence and mortality rates are unknown, because data are not available from developing countries that continue to use large amounts of asbestos. The incidence rate of mesothelioma has decreased in Australia, the United States, and Western Europe, where the use of asbestos was banned or strictly regulated in the 1970s and 1980s, demonstrating the value of these preventive measures. However, in these same countries, the overall number of deaths from mesothelioma has not decreased as the size of the population and the percentage of old people have increased. Moreover, hotspots of mesothelioma may occur when carcinogenic fibers that are present in the environment are disturbed as rural areas are being developed. Novel immunohistochemical and molecular markers have improved the accuracy of diagnosis; however, about 14% (high-resource countries) to 50% (developing countries) of mesothelioma diagnoses are incorrect, resulting in inadequate treatment and complicating epidemiological studies. The discovery that germline BRCA1-asssociated protein 1 (BAP1) mutations cause mesothelioma and other cancers (BAP1 cancer syndrome) elucidated some of the key pathogenic mechanisms, and treatments targeting these molecular mechanisms and/or modulating the immune response are being tested. The role of surgery in pleural mesothelioma is controversial as it is difficult to predict who will benefit from aggressive management, even when local therapies are added to existing or novel systemic treatments. Treatment outcomes are improving, however, for peritoneal mesothelioma. Multidisciplinary international collaboration will be necessary to improve prevention, early detection, and treatment. CA Cancer J Clin 2019;69:402-429.

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Section: Treatmentmentioning

confidence: 99%

Mesothelioma: Scientific clues for prevention, diagnosis, and therapy

Carbone

Adusumilli

Alexander

et al. 2019

CA A Cancer J Clinicians

334

454

View full text Add to dashboard Cite

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“…Residual gross disease cannot be eliminated even with high dose radiation, which is certainly indicative of tumour radioresistance. 41,42 However,…”

Section: View Article Onlinementioning

confidence: 99%

“…42 Mesotheliomas thus lie in an indeterminate clinical zone wherein there is a traditional view of radioresistance, a more recent view of some radiosensitivity, and cell line data which show variable radiosensitivity. The net result is that there is no consensus on an optimal palliative radiotherapy regimen, there is variation in clinical practice worldwide, and there is variation in international guidelines.…”

Section: View Article Onlinementioning

confidence: 99%

“…43 If the survival curve is taken as an indicator, then mesotheliomas are heterogenous for radiation resistance, with tumours varying from radiosensitive to radioresistant. Indeed, de Perrot et al, 42 conclude that ''Increasing evidence has supported that mesotheliomas are sensitive to radiation therapy''. Given that mesotheliomas are variable for Mn levels, (and for their differing clinically-inferred radioresistance), the LA-ICP-MS data may be useful pointers for deciding which patient are likely to obtain the most benefit from intention-to-treat or palliative radiation treatment.…”

Section: View Article Onlinementioning

confidence: 99%

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Distributions of manganese in diverse human cancers provide insights into tumour radioresistance

Doble

Miklos²

2018

Metallomics

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“…Malignant pleural mesothelioma (MPM) is one of the most lethal neoplasms. To address survival benefit, multimodal treatment with extrapleural pneumonectomy (EPP), 1 chemotherapy, 2 and radiotherapy 3 was conducted in accordance with the stage of the disease. Despite recent advances in the above treatments, the long-term outcome of MPM remains insufficient.…”

mentioning

confidence: 99%