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Annals of Oncology Advance Access published online on January 27, 2005
Annals of Oncology, doi:10.1093/annonc/mdi094
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© 2005 European Society for Medical Oncology
Received April 23, 2004
Revised November 9, 2004
Accepted November 9, 2004

Review

Chemotherapy options and new advances in malignant pleural mesothelioma

J. P. C. Steele 1* and A. Klabatsa 1

1 Mesothelioma Research Group, St Bartholomew's Hospital and Medical College, London, UK

* To whom correspondence should be addressed.
J. P. C. Steele, E-mail: jeremy.steele{at}bartsandthelondon.nhs.uk


  Abstract

Malignant pleural mesothelioma continues to be a challenging clinical problem. While traditionally, chemotherapy has been thought to be of only modest benefit to patients with this disease, novel antineoplastic agents and combination regimens incorporating these agents are gradually changing this perception. Early attempts at treatment and palliation with single agents such as doxorubicin met with low response rates and little clinical benefit. However, the recently reported clinical benefits of pemetrexed and raltitrexed in combination with cisplatin are changing the perception about the ability of chemotherapy to affect the natural history of the disease. Other combinations, including cisplatin and gemcitabine, have also shown encouraging response rates and clinical activity. Single-agent therapy with vinorelbine may provide useful palliation with low toxicity. Targeted agents developed through increased understanding of the biology of the disease, used alone or as part of multimodal therapy, may provide major clinical gains in the next few years.

Keywords: cancer; chemotherapy; mesothelioma; novel agents.
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