Transcript:
Dr. Jessica Donington: I'm Jessica Donington. I'm Chief Thoracic Surgeon and Professor of Surgery at the University of Chicago. I had a short review today on updates in mesothelioma. Basically, malignant pleural mesothelioma is a very challenging malignancy of the chest. I covered a whole bunch of the advancements which are going on right now.
One thing that's really exciting and finally happening in mesothelioma is that we have a much more of a standardization of all aspects of its care. That starts from staging and diagnosis through radiologic evaluation. The use of radiation therapy is being much more standardized and is the use of surgery.
This is important in moving the science of this disease forward. It really allows us to all be on the same playing field, to all know that we're talking the same language, and to be able to compare therapies much more universally.
Obviously, the advances in mesothelioma are not as quick as they are for other tumors, but we are making advances. Part of that is determining which patients have better prognosis and which don't. I definitely think we're making some of the treatments more tolerable, especially in terms of radiation and surgery.
There's been a major shift away from extrapleural pneumonectomy to extended pleurectomy and decortication, preserving that lung. We all recognize the value of a lung preservation attempt. Now, with advances in techniques to deliver radiation, we are talking about really exciting trials, like the IMPRINT trial, which can provide adjuvant radiation after a lung-preserving surgery.
The advancements in systemic disease always have many, many different trials looking at all kinds of targeted agents, those that look at BAP1, CDK4, and such. We also have several trials looking at mesothelin as a target.
Still, similar to other areas of oncology, the immunotherapies provide some of the most exciting trials. We are seeing less exciting initial response rates, but now that we are using them in combination, the response rates are a little bit more robust. They're slowly making their way into second-line therapy as a standard of care.
