Sarcomatoid-predominant malignant pleural mesothelioma is an especially
difficult tumor to control. Thoracic surgeons at UCLA seeking to improve
the poor prognosis that comes with this incredibly aggressive cancer looked
at the treatment of non-mesothelioma pleural sarcomas, which is typically
treated with
chemotherapy followed by
surgery and
radiation.
Doctors identified four patients with sarcomatoid-predominant malignant
pleural mesothelioma who had received pre-operative therapy before undergoing
the lung-sparing
pleurectomy/decortication procedure. Three of these patients utilized Ifosfamide/Adriamycin
and one patient Cisplatin/Pemetrexed/ Veglin. Three-fourths of these patients
were found to have pathological responses with 80-99% necrosis, or tumor
death, which is not often seen with standard Cisplatin and Pemetrexed.
Multimodality approaches that utilize Ifosfamide/Adriamycin seem to be
the optimal treatment strategy for sarcomatoid-predominant malignant pleural
mesothelioma patients. In addition, patients who originally are not eligible
for surgery may become so if they see 80% or higher necrosis and remain
free of metastatic growth following chemotherapy.