Leveraging the pleural space for anticancer therapies in pleural mesothelioma.
Lancet Respir Med
; 12(6): 476-483, 2024 Jun.
Article
em En
| MEDLINE
| ID: mdl-38740045
ABSTRACT
Most patients with pleural mesothelioma (PM) present with symptomatic pleural effusion. In some patients, PM is only detectable on the pleural surfaces, providing a strong rationale for intrapleural anticancer therapy. In modern prospective studies involving expert radiological staging and specialist multidisciplinary teams, the population incidence of stage I PM (an approximate surrogate of pleura-only PM) is higher than in historical retrospective series. In this Viewpoint, we advocate for the expansion of intrapleural trials to serve these patients, given the paucity of data supporting licensed systemic therapies in this setting and the uncertainties involved in surgical therapy. We begin by reviewing the unique anatomical and physiological features of the PM-bearing pleural space, before critically appraising the evidence for systemic therapies in stage I PM and previous intrapleural PM trials. We conclude with a summary of key challenges and potential solutions, including optimal trial designs, repurposing of indwelling pleural catheters, and new technologies.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Pleura
/
Neoplasias Pleurais
/
Mesotelioma
Limite:
Humans
Idioma:
En
Revista:
Lancet Respir Med
Ano de publicação:
2024
Tipo de documento:
Article