Over the last year, we’ve been working as part of a James Lind Alliance initiative to find the most importantresearch priorities for mesothelioma, a form of lung cancer – and now I can share with you our top 10 unanswered questions.
Working with the James Lind Alliance
Top 10 mesothelioma research priorities
- Does boosting the immune system (using new agents such as PD-1 or PD-L1) improve response and survival rates for mesothelioma patients?
- Can individualised chemotherapy be given to mesothelioma patients based on predictive factors such as the type of mesothelioma they have?
- What is the best way to monitor patients with diffuse pleural thickening and a negative biopsy who are considered to have a high risk of developing mesothelioma (for example repeat biopsies, imaging, etc)?
- In mesothelioma patients, what is the best second line treatment (for example what chemotherapy drugs should be used if a cancer has recurred following first line chemotherapy, usually with cisplatin and pemetrexed)?
- Which is the most effective current treatment for ascites (excessive accumulation of fluid in the abdominal cavity) (for example Denver shunt, pleurex catheter, etc) in patients with peritoneal mesothelioma?
- What are the relative benefits of immediate standard chemotherapy compared to a watch and wait policy for mesothelioma patients?
- For mesothelioma patients, what is the best follow-up strategy post-treatment, to identify and treat emerging side effects and other problems?
- In mesothelioma, is there a role for intrapleural immunostimmulants (drugs designed to stimulate an anti-cancer immune response, such as corynebacterium parvum extract) in addition to any other treatment?
- Does an annual chest x-ray and/or CT scan and medical examination in high-risk occupations (for example carpenters, plumbers, electricians, shipyard workers) lead to earlier diagnosis of mesothelioma
- What, if any, are the benefits of pleurectomy (pleurectomy/decortication) compared to no surgery, and which mesothelioma patients might benefit?
See the full report for more details on the priorities and other unanswered questions discussed.