In a recent post on the online medical resource OncLive, the director of the New York Mesothelioma Program at the Icahn School of Medicine at Mount Sinai discussed the challenges of randomized controlled trials in assessing the role of surgery in treating the rare form of cancer. Andrea Wolf, MD, MPH, pointed to issues in both standardizing surgical procedures and pathology interpretations.
Physician Extols Success of MARS2 Mesothelioma Trial
While highlighting the many challenges involved in randomizing patients with mesothelioma in surgical trials, Dr. Wolf praised the unique achievements of the researchers conducting the MARS 2 trial. Saying that the group had been successful in randomly assigning patients to receive or not receive surgery while comparing extended pleurectomy decortication surgery against those with no surgery to evaluate outcomes.
Dr. Wolf said that despite the mesothelioma trial’s success, there were limitations in standardizing the surgical operation itself, including variations in technique and the extent of resection. She said that the inconsistent outcomes arising from these differences make it hard to assess the impact that surgery has on patient survival and disease control.
Mesothelioma Pathology Interpretations Create Additional Challenges
In addition to the issues surrounding surgery, Dr. Wolf says there are also challenges in standardizing how pathologists interpret their findings during mesothelioma trials, especially those using blood and tissue samples. Variability in these evaluations, particularly around whether there has been complete microscopic resection, makes it hard to draw definitive conclusions about the benefits of surgery.
Dr. Wolf indicated that the best solution to these ongoing issues is for international mesothelioma researchers to collaborate on treatment protocols and pathology assessments through networks like the International Association for the Study of Lung Cancer. She says that doing so will help refine staging criteria and prognostic factors and help physicians identify which patients are most likely to have improved outcomes from surgery.
If you or someone you love has been diagnosed with malignant mesothelioma, working with an experienced specialist can make a significant difference in your outcomes. For information on treatment and other topics, contact the Patient Advocates at Mesothelioma.net today at 1-800-692-8608.
