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The Timing of Chemotherapy in the Multimodality Treatment of Malignant Pleural Mesothelioma

Chemotherapy used in multimodality treatment of malignant pleural mesothelioma is typically performed within 4-6 weeks prior to or after surgery, and various strategies have been used with regard to the timing of chemotherapy within a multimodality treatment.

Doctors at UCLA identified 121 patients who had undergone the pleurectomy/decortication surgery followed by adjuvant radiation therapy and received chemotherapy only after the first recurrence of the disease. The results of receiving delayed chemotherapy were comparable or better to those reported for “trimodality” therapy including the recent MARS trial. These findings suggest that a more rational and conservative approach to multimodality treatment of patients with malignant pleural mesothelioma may be warranted.

Multimodality Therapy is the combination of surgery, radiation, and chemotherapy; and for malignant pleural mesothelioma patients eligible for surgery, is almost always associated with the longest survival rates. Survival of patients who receive this type of treatment varies from 16 to 22 months, depending on the staging, type of surgery, cell type, as well as other factors.