Systemic Chemotherapy in Multimodal Treatment

Posted on: October 17, 2023 *Updated on: May 27, 2024

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Systemic chemotherapy is an important component of multimodal treatment for mesothelioma, especially pleural mesothelioma. The combination of cisplatin and pemetrexed is commonly used and FDA-approved for treating malignant pleural mesothelioma.

Multimodal Treatment Approach

Multimodal treatment generally involves combining surgery, chemotherapy, and radiation therapy, either sequentially or in an integrated manner, to improve survival and quality of life for patients.

Surgery Types

• P/D (Pleurectomy/Decortication): This is a surgical procedure that removes the lining of the lung and part of the diaphragm to treat pleural mesothelioma. It is considered a lung-sparing surgery.
• EPP (Extrapleural Pneumonectomy): This is a more radical surgery that removes the lung, part of the diaphragm, and other nearby structures. This procedure is often used in more advanced cases and is considered riskier.

Chemotherapy Types

• Neoadjuvant chemotherapy: Given before surgery to shrink tumors.
• Adjuvant chemotherapy: Given after surgery to kill any remaining cancer cells.

Radiation

Radiation therapy may also be administered either before or after surgery to try to kill cancer cells or shrink tumors.

Survival Outcomes

Survival statistics can vary depending on the treatment combinations used:

• 32 months average survival for P/D with neoadjuvant and adjuvant chemotherapy.
• 32 months average survival for P/D with adjuvant chemotherapy and radiation.
• 18 months average survival for EPP with adjuvant chemotherapy and radiation.

It’s worth mentioning that survival statistics are just averages and individual patient outcomes can vary widely.

Consult Medical Experts

It’s crucial for mesothelioma patients to consult with a multidisciplinary team of experts, including oncologists, thoracic surgeons, and radiologists, to discuss their specific cases and determine the most appropriate treatment strategy.