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ERS/ESTS/EACTS/ESTRO guidelines for the management of malignant pleural mesothelioma.

  • Scherpereel A Pulmonary and Thoracic Oncology, Univ. Lille, CHU Lille, INSERM U1189, OncoThAI, Lille, France arnaud.scherpereel@chru-lille.fr.
  • Opitz I Dept of Thoracic Surgery, University Hospital Zurich, Zurich, Switzerland.
  • Berghmans T Thoracic Oncology Clinic, Institut Jules Bordet, Brussels, Belgium.
  • Psallidas I Oxford Centre for Respiratory Medicine, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
  • Glatzer M Dept of Radiation Oncology, Kantonsspital St Gallen, St Gallen, Switzerland.
  • Rigau D Iberoamerican Cochrane Center, Barcelona, Spain.
  • Astoul P Dept of Thoracic Oncology, Pleural Diseases and Interventional Pulmonology, Hôpital Nord, Aix-Marseille University, Marseille, France.
  • Bölükbas S Dept of Thoracic Surgery, Evang, Kliniken Essen-Mitte, Essen, Germany.
  • Boyd J European Lung Foundation, Sheffield, UK.
  • Coolen J Dept of Imaging and Pathology, KU Leuven, Leuven, Belgium.
  • De Bondt C Dept of Pulmonology and Thoracic Oncology, Antwerp University and Antwerp University Hospital, Antwerp, Belgium.
  • De Ruysscher D Dept of Radiation Oncology (Maastro Clinic), Maastricht University Medical Center+, GROW Research Institute, Maastricht, The Netherlands.
  • Durieux V Bibliothèque des Sciences de la Santé, Université libre de Bruxelles (ULB), Brussels, Belgium.
  • Faivre-Finn C The Christie NHS Foundation Trust, The University of Manchester, Manchester, UK.
  • Fennell D Leicester Cancer Research Centre, University of Leicester and University of Leicester Hospitals NHS Trust, Leicester, UK.
  • Galateau-Salle F National Reference Center for Pleural Malignant Mesothelioma and Rare Peritoneal Tumors MESOPATH, Dept of Biopathology, Centre Leon Berard, Lyon, France.
  • Greillier L Aix Marseille University, Assistance Publique Hôpitaux de Marseille, Inserm UMR1068, CNRS UMR7258, Dept of Multidisciplinary Oncology and Therapeutic Innovations, Marseille, France.
  • Hoda MA Dept of Thoracic Surgery, Medical University of Vienna, Vienna, Austria.
  • Klepetko W Dept of Thoracic Surgery, Medical University of Vienna, Vienna, Austria.
  • Lacourt A Univ. Bordeaux, INSERM, Bordeaux Population Health Research Center, team EPICENE, UMR 1219, Bordeaux, France.
  • McElnay P Newcastle University, Newcastle upon Tyne, UK.
  • Maskell NA Academic Respiratory Unit, Bristol Medical School, University of Bristol, Bristol, UK.
  • Mutti L Teaching Hosp. Vercelli/Gruppo Italiano Mesotelioma, Italy.
  • Pairon JC INSERM U955, Equipe 4, Université Paris-Est Créteil, and Service de Pathologies professionnelles et de l'Environnement, Institut Santé-Travail Paris-Est, CHI Créteil, Créteil, France.
  • Van Schil P Dept Thoracic and Vascular Surgery, Antwerp University and Antwerp University Hospital, Antwerp, Belgium.
  • van Meerbeeck JP Dept of Pulmonology and Thoracic Oncology, Antwerp University and Antwerp University Hospital, Antwerp, Belgium.
  • Waller D Barts Thorax Centre, St Bartholomew's Hospital, London, UK.
  • Weder W Dept of Thoracic Surgery, University Hospital Zurich, Zurich, Switzerland.
  • Cardillo G Unit of Thoracic Surgery, Azienda Ospedaliera San Camillo Forlanini, Rome, Italy.
  • Putora PM Dept of Radiation Oncology, Kantonsspital St Gallen, St Gallen, Switzerland.
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  • 2020-05-27
Published in:
  • The European respiratory journal. - 2020
Pulmonary and Respiratory Medicine
English The European Respiratory Society (ERS)/European Society of Thoracic Surgeons (ESTS)/European Association for Cardio-Thoracic Surgery (EACTS)/European Society for Radiotherapy and Oncology (ESTRO) task force brought together experts to update previous 2009 ERS/ESTS guidelines on management of malignant pleural mesothelioma (MPM), a rare cancer with globally poor outcome, after a systematic review of the 2009-2018 literature. The evidence was appraised using the Grading of Recommendations, Assessment, Development and Evaluation approach. The evidence syntheses were discussed and recommendations formulated by this multidisciplinary group of experts. Diagnosis: pleural biopsies remain the gold standard to confirm the diagnosis, usually obtained by thoracoscopy but occasionally via image-guided percutaneous needle biopsy in cases of pleural symphysis or poor performance status. Pathology: standard staining procedures are insufficient in ∼10% of cases, justifying the use of specific markers, including BAP-1 and CDKN2A (p16) for the separation of atypical mesothelial proliferation from MPM. Staging: in the absence of a uniform, robust and validated staging system, we advise using the most recent 2016 8th TNM (tumour, node, metastasis) classification, with an algorithm for pre-therapeutic assessment. Monitoring: patient's performance status, histological subtype and tumour volume are the main prognostic factors of clinical importance in routine MPM management. Other potential parameters should be recorded at baseline and reported in clinical trials. Treatment: (chemo)therapy has limited efficacy in MPM patients and only selected patients are candidates for radical surgery. New promising targeted therapies, immunotherapies and strategies have been reviewed. Because of limited data on the best combination treatment, we emphasise that patients who are considered candidates for a multimodal approach, including radical surgery, should be treated as part of clinical trials in MPM-dedicated centres.
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  • English
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bronze
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https://sonar.ch/global/documents/169116
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