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Mesothelioma pp 221–233Cite as

Role of Chemotherapy in the Management of Malignant Pleural Mesothelioma

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Abstract

Malignant pleural mesothelioma (MPM) is a highly aggressive tumor, with poor prognosis and limited treatment options. Radical multimodality strategies (surgery with chemo- and radiotherapy) are only suitable for a minority of patients, and the evidence to support their efficacy is low. Cytotoxic chemotherapy represents the only therapeutic option with a proven survival benefit in patients with MPM. Following the results of a large phase III trial, the combination of cisplatin and pemetrexed has been established as the standard of care for unresectable MPM. For patient unfit to receive this doublet, schedules with carboplatin have been explored, with similar outcomes. Another first-line option includes the use of raltitrexed combined with cisplatin. Despite extensive efforts and several trials, no standard treatment is available after progression on platinum-containing regimens. In the second-line setting, if clinical trials are not available, single-agent therapy with vinorelbine or gemcitabine may be considered. Alternatively, patients achieving a prolonged benefit from first-line pemetrexed-platinum treatment may be candidate to rechallenge with pemetrexed-based regimens.

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Authors and Affiliations

  1. Division of Thoracic Oncology, European Institute of Oncology, Milan, Italy

    Letizia Gianoncelli

  2. Fondazione Buzzi Unicem, Casale Monferrato, Italy

    Letizia Gianoncelli & Giovanni Luca Ceresoli

  3. Department of Oncology, Thoracic and GU Oncology Unit, Cliniche Humanitas Gavazzeni, Bergamo, Italy

    Maria Bonomi & Giovanni Luca Ceresoli

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  1. Letizia Gianoncelli
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  2. Maria Bonomi
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  3. Giovanni Luca Ceresoli
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Correspondence to Giovanni Luca Ceresoli .

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Editors and Affiliations

  1. Department of Medical Oncology, Humanitas Gavazzeni Hospital, Bergamo, Italy

    Giovanni Luca Ceresoli

  2. Scientific Direction, Humanitas Gavazzeni Hospital, Bergamo, Italy

    Emilio Bombardieri

  3. Department of Oncology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy

    Maurizio D'Incalci

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Gianoncelli, L., Bonomi, M., Ceresoli, G.L. (2019). Role of Chemotherapy in the Management of Malignant Pleural Mesothelioma. In: Ceresoli, G., Bombardieri, E., D'Incalci, M. (eds) Mesothelioma. Springer, Cham. https://doi.org/10.1007/978-3-030-16884-1_15

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