Biologie en behandeling van het maligne mesothelioom
07-12-2006In twee recent verschenen artikelen wordt een overzicht gegeven van de biologische processen die mesothelioom veroorzaken en de behandelingen die toegepast worden. In beide artikelen wordt geconcludeerd dat deze aandoening nog steeds een slechte prognose heeft. Wel zijn er de laatste jaren bescheiden verbeteringen geboekt door chemotherapeutische behandeling met een combinatie van de middelen cisplatine en pemetrexed of raltitrexed. Meer kennis over de moleculaire processen is echter nodig om meer effectieve behandelingen te kunnen vinden. Bron: Stahel RA ,(2006). Malignant pleural mesothelioma: A new standard of care, Lung Cancer, doi:10.1016/j.lungcan.2006.09.011. Zucalia, P.A. & Giaccone, G. (2006). Biology and management of malignant pleural mesothelioma. European Journal of Cancer 42, 2707-2714.
Stahel RA ,(2006). Malignant pleural mesothelioma: A new standard of care, Lung Cancer, doi:10.1016/j.lungcan.2006.09.011
Abstract
Malignant pleural mesothelioma (MPM) is an asbestos-associated cancer that occurs
most commonly in the pleural cavities and generally has a poor prognosis. A rise in the incidence of this fatal disease, which, in the past has been considered to be relatively refractory to therapy, is predicted over the next decade. The realisation that patients can benefit from systemic chemotherapy and more aggressive multimodal approaches, including extrapleural pneumonectomy (EPP), in earlier stages of disease now provides the opportunity to offer more effective treatment for this disease.
Zucalia, P.A. & Giaccone, G. (2006). Biology and management of malignant pleural mesothelioma. European Journal of Cancer 42, 2707-2714.
Abstract
Malignant mesothelioma is an aggressive tumour, with a poor prognosis and an increasing
incidence as a result of widespread exposure to asbestos. The results of the treatments
available are poor. Surgery and radiotherapy have a limited role in highly selected patients
and systemic therapy is the only potential treatment option for the majority of patients.
Despite some definite activity of the novel antifolates such as pemetrexed and raltitrexed,
the results, even in combination with platinating agents, are still modest, with a median
survival of approximately one year. The better understanding of the biology of mesothelioma
makes the assessment of a number of targeted agents particularly interesting. Unfortunately,
the targeted agents imatinib, gefitinib, erlotinib and thalidomide have been
shown to be ineffective in unselected patients. Studies with anti-angiogenesis agents are
ongoing. An improvement of the knowledge of major molecular pathways involved in
malignant mesothelioma is needed in order to define proper targets for the systemic treatment
of this disease.