A REVIEW OF CHEMOTHERAPY TRIALS FOR MALIGNANT MESOTHELIOMA

Treatment of malignant pleural mesothelioma continues to be frustratin g regardless of the modality employed. Numerous trials of chemotherape utic agents have been performed, but until recently, these studies wer e small and subject to inaccuracies of disease measurement. To our kno wledge, no chemotherapeutic regimen has emerged as a standard of care. A review of the literature reveals that small activity against this d isease has been shown by the anthracyclines, platinum compounds, and a lkylating agents, whereas higher activity has been reported with the a ntimetabolites. The plant alkaloids have not demonstrated any activity against mesothelioma. Dose-escalated chemotherapeutic regimens may of fer an advantage, whereas combination chemotherapy has not shown any b enefit over single-agent therapy. Favorable responses have been report ed with the administration of intrapleural biological response modifie rs. Further trials and the investigation of new agents in the treatmen t of this disease are necessary.