Current State of Pleural-Directed Adjuncts Against Malignant Pleural Mesothelioma

Multimodality therapy including surgical resection is the current paradigm in treating malignant pleural mesothelioma (MPM), a thoracic surface cancer without cure. The main limitation of all surgical approaches is the lack of long-term durability because macroscopic complete resection (R1 resection...

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Autores principales: Choi, Agnes Y., Singh, Anand, Wang, Danyi, Pittala, Karthik, Hoang, Chuong D.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9108281/
https://www.ncbi.nlm.nih.gov/pubmed/35586499
http://dx.doi.org/10.3389/fonc.2022.886430
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author Choi, Agnes Y.
Singh, Anand
Wang, Danyi
Pittala, Karthik
Hoang, Chuong D.
author_facet Choi, Agnes Y.
Singh, Anand
Wang, Danyi
Pittala, Karthik
Hoang, Chuong D.
author_sort Choi, Agnes Y.
collection PubMed
description Multimodality therapy including surgical resection is the current paradigm in treating malignant pleural mesothelioma (MPM), a thoracic surface cancer without cure. The main limitation of all surgical approaches is the lack of long-term durability because macroscopic complete resection (R1 resection) commonly predisposes to locoregional relapse. Over the years, there have been many studies that describe various intrapleural strategies that aim to extend the effect of surgical resection. The majority of these approaches are intraoperative adjuvants. Broadly, there are three therapeutic classes that employ diverse agents. The most common, widely used group of adjuvants are comprised of direct therapeutics such as intracavitary chemotherapy (± hyperthermia). By comparison, the least commonly employed intrathoracic adjuvant is the class comprised of drug-device combinations like photodynamic therapy (PDT). But the most rapidly evolving (new) class with much potential for improved efficacy are therapeutics delivered by specialized drug vehicles such as a fibrin gel containing cisplatin. This review provides an updated perspective on pleural-directed adjuncts in the management of MPM as well as highlighting the most promising near-term technology breakthroughs.
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spelling pubmed-91082812022-05-17 Current State of Pleural-Directed Adjuncts Against Malignant Pleural Mesothelioma Choi, Agnes Y. Singh, Anand Wang, Danyi Pittala, Karthik Hoang, Chuong D. Front Oncol Oncology Multimodality therapy including surgical resection is the current paradigm in treating malignant pleural mesothelioma (MPM), a thoracic surface cancer without cure. The main limitation of all surgical approaches is the lack of long-term durability because macroscopic complete resection (R1 resection) commonly predisposes to locoregional relapse. Over the years, there have been many studies that describe various intrapleural strategies that aim to extend the effect of surgical resection. The majority of these approaches are intraoperative adjuvants. Broadly, there are three therapeutic classes that employ diverse agents. The most common, widely used group of adjuvants are comprised of direct therapeutics such as intracavitary chemotherapy (± hyperthermia). By comparison, the least commonly employed intrathoracic adjuvant is the class comprised of drug-device combinations like photodynamic therapy (PDT). But the most rapidly evolving (new) class with much potential for improved efficacy are therapeutics delivered by specialized drug vehicles such as a fibrin gel containing cisplatin. This review provides an updated perspective on pleural-directed adjuncts in the management of MPM as well as highlighting the most promising near-term technology breakthroughs. Frontiers Media S.A. 2022-05-02 /pmc/articles/PMC9108281/ /pubmed/35586499 http://dx.doi.org/10.3389/fonc.2022.886430 Text en Copyright © 2022 Choi, Singh, Wang, Pittala and Hoang https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Oncology
Choi, Agnes Y.
Singh, Anand
Wang, Danyi
Pittala, Karthik
Hoang, Chuong D.
Current State of Pleural-Directed Adjuncts Against Malignant Pleural Mesothelioma
title Current State of Pleural-Directed Adjuncts Against Malignant Pleural Mesothelioma
title_full Current State of Pleural-Directed Adjuncts Against Malignant Pleural Mesothelioma
title_fullStr Current State of Pleural-Directed Adjuncts Against Malignant Pleural Mesothelioma
title_full_unstemmed Current State of Pleural-Directed Adjuncts Against Malignant Pleural Mesothelioma
title_short Current State of Pleural-Directed Adjuncts Against Malignant Pleural Mesothelioma
title_sort current state of pleural-directed adjuncts against malignant pleural mesothelioma
topic Oncology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9108281/
https://www.ncbi.nlm.nih.gov/pubmed/35586499
http://dx.doi.org/10.3389/fonc.2022.886430
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