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Overzichtsstudies naar ontwikkelingen in de behandeling van mesothelioom

15-05-2008 00:00

Chemotherapie is momenteel de behandeling die het meest wordt toegepast bij niet-operabele mesothelioompatienten. Het gebruik van antifolaten in combinatie met platinum geeft daarbij de grootste kans op langere overleving. Bij patienten die wel geopereerd kunnen worden biedt een combinatie van opereren, bestralen en chemo (trimodale of multimodale behandeling) de beste overlevingskansen. Er is geen standaardtherapie voor de tweedelijnsbehandeling. Bron: Fennell, D., et al. (2008). Advances in the systemic therapy of malignant pleural mesothelioma. Nature Clinical Practice, 5, 3, p. 136-147. Kaufman, A.J. &. Pass, H.I. (2008). Current concepts in malignant pleural mesothelioma. Expert Rev. Anticancer Ther. 8(2), 293-303.

Kaufman, A.J. &. Pass, H.I. (2008). Current concepts in malignant pleural mesothelioma. Expert Rev. Anticancer Ther. 8(2), 293-303.
Abstract
Malignant pleural mesothelioma (MPM) is a rare but lethal cancer associated with asbestos exposure. Worldwide, the incidence of MPM is expected to increase over the next 20 years. The molecular and genetic profiling of MPM tumors and patients, and improved understanding of the pathogenesis of MPM may lead to novel diagnostic, preventative and therapeutic strategies. Treatment options for MPM remain limited and no consensus exists at this time. Multimodality therapy that combines surgery, chemotherapy and radiation offers the best chance for long-term survival in select patients.

Fennell, D., et al. (2008). Advances in the systemic therapy of malignant pleural mesothelioma. Nature Clinical Practice, 5, 3, p. 136-147.
Abstract

Malignant pleural mesothelioma is an aggressive thoracic malignancy associated with exposure to asbestos, and its incidence is anticipated to increase during the first half of this century. Chemotherapy is the mainstay of treatment, yet sufficiently robust evidence to substantiate the current standard of care has emerged only in the past 5 years. This Review summarizes the evidence supporting the clinical activity of chemotherapy, discusses the use of end points for its assessment and examines the influence of clinical and biochemical prognostic factors on the natural history of malignant pleural mesothelioma. Early-phase clinical trials of second-line and novel agents are emerging from an increased understanding of mesothelioma cell biology. Coupled with high-quality translational research, such developments have real potential to improve the outlook of patients at a time of increasing incidence.