Ontwikkelingen in de behandeling van het maligne mesothelioom

- For many years there has been a search for an effective treatment of malignant pleural mesothelioma.

- Surgery is of limited applicability and is reserved for special cases, in which it is combined with radiation therapy.

- In the previous century, many cytostatic agents have been tested, alone or in combination, but the response was limited, the median survival time was unchanged and the toxicity was high.

- New drugs, including the new antifolates, are being used much more often in the treatment of malignant pleural mesothelioma in combination with a platinum derivative.

- Cytostatics such as pemetrexed, an antifolate, and to a lesser extent raltitrexed, have shown good response rates and increased survival in phase III studies, but the survival benefit evaporates within 2 years.

- Inhibitors of angiogenesis and of epidermal growth factor are being tested, but they have shown only limited activity until now.

- The current studies focus on the use of chemotherapy and biological agents as part of a more complex treatment schedule.

Ned Tijdschr Geneeskd 2005;149:747-53