HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Valerie W. Rusch Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Rusch, V. W. Search for Related Content PubMed PubMed Citation Articles by Rusch, V. W.

Eur J Cardiothorac Surg 2007;31:534-535. doi:10.1016/j.ejcts.2007.01.011
Copyright © 2007, European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved

Editorial comment

A phase II study of intrapleural immunochemotherapy, pleurectomy/decortication, radiotherapy, systemic chemotherapy, and long-term subcutaneous IL-2 in stage II–III malignant pleural mesothelioma

Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, C-868, New York, NY 10021, United States

^_* Tel.: +1 212 639 8695; fax: +1 212 717 3682. (Email: ruschv@mskcc.org).

The first 20% of the full text of this article appears below.

Malignant pleural mesothelioma (MPM) is an uncommon and usually fatal malignancy for which novel therapies are clearly needed. In this issue of the journal, Lucchi et al. [1] report the results of a phase II trial of combined modality therapy for patients with clinical stages II and III MPM, including preoperative intrapleural immunochemotherapy, pleurectomy/decortication (P/D), adjuvant radiation (30 Gy), and systemic chemotherapy followed by long-term subcutaneous interleukin-2 (IL-2). From 1999 to 2004, 49 patients were entered on study and all patients completed the planned treatment with acceptable toxicity. The 5-year actuarial survival was 23.3% and the most common site of relapse was local (37 of 49 patients). The authors conclude that this treatment strategy provides good palliation and deserves further study, perhaps through the addition of intracavitary hyperthermic chemotherapy or the use of new drugs.

It is important to consider the design of this trial within the context of recent studies in MPM. The authors contend that ‘nothing has changed in the early diagnosis and, more important, in the prognosis of MPM patients’, implying that a lack of standard treatment justifies their selection of a complex multimodality treatment strategy. However, during the past 20 years, there have been major advances in several areas, including diagnostic and staging methods, the selection of patients for surgery, a reduction in surgical mortality, significant improvements in local control through the addition of high dose hemithoracic radiation to extrapleural pneumonectomy (EPP), the development of more effective chemotherapy drugs, and an emerging understanding of MPM biology. These advances . . . [Full Text of this Article]