Propose therapeutic options for the treatment of Mesothelioma.
Mesothelioma may be treated with surgery, chemotherapy, radiotherapy, or a combination of modalities. Surgery is an option for patients with disease confined to the pleural space, but resection is relied upon even in more widespread cases because radiation and chemotherapy are ineffective as primary treatments. With surgery alone recurrence rates are very high.
Pleurectomy is a limited surgical procedure that involves dissection of the tumor from the pleura and has a mortality rate of 2%. A more extensive approach is extrapleural pneumonectomy, which involves en bloc resection of the pleura. Although this second approach has a higher mortality rate it provides better local control of the disease.
Active chemotherapeutic agents include anthracycline, platinum, and alkylating agents, which have effective rates of 10-20%. Cisplatin is the drug used most often in phase III trials.
Radiation therapy does not affect survival rate but is used as a palliative measure in combination with other treatments.