Radiotherapy add-on boosts OS in localized malignant pleural mesothelioma

  • Lung Cancer

  • curated by Kelli Whitlock Burton
  • Univadis Clinical Summaries
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Takeaway

  • In patients with localized malignant pleural mesothelioma (MPM), adding radiotherapy to surgery+chemotherapy is associated with significantly better OS compared with surgery+chemotherapy alone.

Why this matters

  • MPM is highly aggressive, and research into the most effective treatment option has yielded conflicting results.

Study design

  • 1015 patients diagnosed with MPM between 1976 and 2016 from the Surveillance, Epidemiology, and End Results database.
  • Funding: None.

Key results

  • 66.8% received surgery+chemotherapy and 33.2% received surgery, chemotherapy, and radiotherapy.
  • Trimodal therapy was associated with improved OS (HR, 0.83; P=.008) on univariate analysis, but after adjustment, the difference was no longer significant (HR, 0.91; P=.167).
  • Among patients with localized disease, those receiving trimodal therapy had longer median OS than those who received surgery+chemotherapy (24 vs 15 months).
  • After multivariable analysis, trimodal therapy was associated with significantly better OS, but only with localized disease (adjusted HR, 0.68; P=.025).
  • Independent risk factors for poor OS included age ≥70 years, male sex, and nonepithelioid histology.
  • Female sex, diagnosis after 2005, and left-sided disease were independently associated with better OS.

Limitations

  • No data on type of chemotherapy or radiation dose.