Correspondence Hemithoracic radiotherapy for mesothelioma: lack of benefit or lack of statistical power?

In The Lancet Oncology, Rolf Stahel and colleagues1 conclude that results from their trial do not support use of hemithoracic radiotherapy after neoadjuvant chemotherapy and extrapleural pneumonectomy in patients with malignant pleural mesothelioma. Median locoregional relapse-free survival from surgery was 7·6 months (95% CI 4·5–10·7) in patients not treated with radiotherapy compared with 9·4 months (6·5–11·9) in the radiotherapy group. The authors, leaders in the treatment of this cancer, should be commended for having undertaken a large prospective trial, but we are concerned that their conclusions are not supported by the data and could be misinterpreted.
Source: The Lancet Oncology - Category: Cancer & Oncology Authors: Tags: Correspondence Source Type: research

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Authors: Auer RC, Sivajohanathan D, Biagi J, Conner J, Kennedy E, May T Abstract Objective: The purpose of the present review was to provide evidence-based guidance about the provision of cytoreductive surgery (crs) with hyperthermic intraperitoneal chemotherapy (hipec) in the treatment of peritoneal cancers. Methods: The guideline was developed by the Program in Evidence-Based Care together with the Surgical Oncology Program at Ontario Health (Cancer Care Ontario) through a systematic review of relevant literature, patient- and caregiver-specific consultation, and internal and external reviews. Results: Re...
Source: Current Oncology - Category: Cancer & Oncology Tags: Curr Oncol Source Type: research
Neoadjuvant chemotherapy — often used before aggressive surgery — has shown no definitive survival benefit for patients with pleural mesothelioma cancer, according to a recent study at the Duke University Medical Center. The study strengthened the growing belief among mesothelioma specialists that the combination of chemotherapy drugs cisplatin and pemetrexed might be a more effective treatment after surgery than before. “I think the study provides a little more evidence to support what those of us were seeing, that
Source: Asbestos and Mesothelioma News - Category: Environmental Health Authors: Source Type: news
CONCLUSIONS: The pPCI strongly differs from the sPCI for patients undergoing CRS for peritoneal disease and may provide a more accurate evaluation of the peritoneal disease extent. Further studies are needed to determine its prognostic value compared with sPCI, and consensus guidelines are needed for calculating it. PMID: 32040698 [PubMed - as supplied by publisher]
Source: Ann Oncol - Category: Cancer & Oncology Authors: Tags: Ann Surg Oncol Source Type: research
Conclusion: This is the first description of gC1qR expression in MPM. The data identify gC1qR as a potential new prognostic factor in patients treated with surgery and chemotherapy.
Source: Frontiers in Oncology - Category: Cancer & Oncology Source Type: research
Joe Abdo1, Christopher S. Wichman2, Nicholas E. Dietz1,3, Pawel Ciborowski4, John Fleegel1, Sumeet K. Mittal1,5 and Devendra K. Agrawal1* 1Department of Clinical and Translational Science, Creighton University School of Medicine, Omaha, NE, United States 2Department of Biostatistics, College of Public Health, University of Nebraska Medical Center, Omaha, NE, United States 3Department of Pathology, CHI Health Creighton University Medical Center, College of Medicine, Omaha, NE, United States 4Department of Pharmacology, University of Nebraska Medical Center, Omaha, NE, United States 5Norton Thoracic Institute, St....
Source: Frontiers in Oncology - Category: Cancer & Oncology Source Type: research
A team of researchers at the Hyogo College of Medicine in Nishinomiya, Japan, studied the outcomes for pleural mesothelioma patients who received surgery at their facility between 2004 and 2016. The results: More aggressive surgery did not help mesothelioma patients live longer. “We showed that introducing less-invasive surgical techniques could decrease surgical risks without compromising survival,” the researchers wrote in their study, published in January in Seminars in Thoracic and Cardiovascular Surgery. “Surgery that is less invasive than conventional extrapleural pneumonectomy could achieve lower ...
Source: Asbestos and Mesothelioma News - Category: Environmental Health Authors: Source Type: news
Intraoperative photodynamic therapy combined with novel proton radiation improved survival time significantly for recent patients with advanced-stage pleural mesothelioma. The study — the first to measure the impact of this combination — involved 10 consecutive patients treated at the University of Pennsylvania’s Abramson Cancer Center. The treatment regimen resulted in a 90 percent, two-year disease control rate and an impressive 30.3-month median overall survival from the time of diagnosis. All 10 patients were diagnosed before treatment began with stage 3 or stage 4 disease, which typically results in ...
Source: Asbestos and Mesothelioma News - Category: Environmental Health Authors: Source Type: news
Thoracic surgeon Dr. Sunil Singhal at the Abramson Cancer Center has developed glowing tumor technology that should increase the effectiveness of aggressive surgery for malignant pleural mesothelioma. Singhal has shown recently that by adding a contrast agent that makes tumor cells glow, a more complete surgery can be done. This potentially avoids the now almost-inevitable cancer recurrence. “This is a big deal. We could potentially help a lot of patients with this,” Singhal told Asbestos.com. “It could change the entire field [of surgery for mesothelioma].” Singhal and his colleagues from the Abram...
Source: Asbestos and Mesothelioma News - Category: Environmental Health Authors: Source Type: news
CONCLUSIONS: The overall strength of the evidence gathered in this review is low and there is a lack of available evidence to support the use of radical multimodality therapy in routine clinical practice (particularly as one trial suggests greater harm). Given the added cost of multimodality treatment and the possible increase in risk of adverse effects, the lack of evidence of their effectiveness probably means that these interventions should currently be limited to clinical trials alone. PMID: 29309720 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - Category: General Medicine Authors: Tags: Cochrane Database Syst Rev Source Type: research
Authors: Predina JD, Keating J, Venegas O, Nims S, Singhal S Abstract Non-small Cell Lung Cancer (NSCLC) remains a deadly disease despite aggressive treatment protocols which incorporate chemotherapy, radiation and surgery. These traditional approaches have reached a plateau in therapeutic benefit. There is emerging evidence suggesting that immunotherapy can serve as an alternative treatment modality for NSCLC. Our group has nearly two decades of experience involving immuno-gene therapy with Ad.hIFN-α and Ad.hIFN-β in human mesothelioma trials, and has observed both safety and efficacy in treatment of Th...
Source: Discovery Medicine - Category: Research Tags: Discov Med Source Type: research
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