Treatment of Patients with Malignant Peritoneal Mesothelioma

Abstract

Malignant peritoneal mesothelioma is a rare malignancy arising from the serosa of the peritoneal cavity. It is diagnosed based on suspicious findings on cross sectional imaging and a tissue biopsy showing confirmatory histologic and immunohistochemical features. The disease is hallmarked by its propensity to progress mainly in the peritoneal cavity. In selected patients, surgical cytoreduction and hyperthermic intra-operative peritoneal chemotherapy has become the initial preferred treatment and is associated with provide prolonged in many patients. Systemic chemotherapy using a couplet of cisplatin or gemcitabine with pemetrexed has modest response rates and duration of response. Expression of PD-L1 has been demonstrated in peritoneal mesothelioma tumors and there has been significant interest in the use of check point blockade targeted against PD-L1 in this clinical setting. Future clinical research using a combination of check point blockade with surgical cytoreduction is a high clinical priority.

Cytoreductive surgery and intraperitoneal hyperthermic chemotherapy for malignant peritoneal mesothelioma

“…Nevertheless, in 2004, the U.S. Food and Drug Administration (Rockville, Maryland) approved the combination of cisplatin and pemetrexed as a fi rst-line medical therapy for patients with DMPM. In 2008, carboplatin was approved as an alternative to cisplatin (22). More recently, a signifi cant interest has been paid to the use of immune checkpoint inhibitors, either alone or in combination with chemotherapy, in patients with mesothelioma.…”

“…More recently, a signifi cant interest has been paid to the use of immune checkpoint inhibitors, either alone or in combination with chemotherapy, in patients with mesothelioma. Most of the studies have been focused on patients with pleural mesothelioma, and the exact relevance of the results of this study for patients with DMPM is unknown (22). Based on the results of the PROMISE-meso trial (23) and Checkmate-743 study, which compared dual checkpoint blockade versus chemotherapy as a In our group, all patients were referred to a multidisciplinary team care (MDT) to determine the best therapeutic option.…”