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01.09.2016 | consensus report | Ausgabe 17-18/2016 Open Access

Wiener klinische Wochenschrift 17-18/2016

Management of malignant pleural mesothelioma—part 2: therapeutic approaches

Consensus of the Austrian Mesothelioma Interest Group (AMIG)

Zeitschrift:
Wiener klinische Wochenschrift > Ausgabe 17-18/2016
Autoren:
Ass. Prof. Dr. Mir Alireza Hoda, Thomas Klikovits, Madeleine Arns, Karin Dieckmann, Sabine Zöchbauer-Müller, Christian Geltner, Bernhard Baumgartner, Peter Errhalt, Barbara Machan, Wolfgang Pohl, Jörg Hutter, Josef Eckmayr, Michael Studnicka, Martin Flicker, Peter Cerkl, Walter Klepetko
Wichtige Hinweise
All authors contribute on behalf of the Austrian Mesothelioma Interest Group (AMIG).

Summary

Treatment of malignant pleural mesothelioma (MPM) depends on performance status of the patient, tumor stage, and histological differentiation. Chemotherapy (CHT) can be administered as first- and second-line treatment in unresectable MPM or as neoadjuvant or adjuvant treatment before or after surgery. A combination of an antifolate and platinum-based CHT is the only approved standard of care. Several targeted and immunotherapies are in evaluation and further studies are warranted to determine the therapeutic value of these new treatment options. Radiotherapy (RT) can be considered either as adjuvant treatment after surgery or for palliation of pain-related tumor growth. Recent data support the use of RT in a neoadjuvant setting. Macroscopic complete resection by pleurectomy/decortication (P/D) or extrapleural pneumonectomy (EPP) is indicated in selected patients with good performance status. Surgery should only be applied as part of a multimodality treatment (MMT) in combination with chemo- and/or radiotherapy. In a large number of cases, palliative attempts are needed to improve quality of life and to achieve symptom control.

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