Treating progressive malignant pleural mesothelioma

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Treating progressive malignant pleural mesothelioma

Isolated thoracic perfusion with chemofiltration: Treating progressive malignant pleural mesothelioma

treating progressive malignant pleural mesotheliomaA recent peer reviewed paper on the success of Isolated Thoracic Perfusion (a form of Regional Chemotherapy) therapy in treating progressive malignant pleural mesothelioma has been published. Progressive malignant pleural mesothelioma is the type of lung cancer with links to asbestos. This cancer is currently considerate incurable and has limited treatment options.

The medical team of Prof. Karl R. Aigner, Dr. Emir Selak and Dr. Sabine Gailhofer have conducted the study at the Department of Surgical Oncology at Medias Klinikum and produced the paper.  Dr. Amy Norman has reviewed this paper for single blind peer review. Dr. Ingrid Espinoza approved the paper for publication as an editor.

Below is the abstract of the publication on treating progressive malignant pleural mesothelioma.

Isolated thoracic perfusion with chemofiltration for progressive malignant pleural mesothelioma


Therapy of malignant pleural mesothelioma and especially the adequate role of surgery in this context remain the subject of controversial discussions. Thus, radical surgery in particular, while a possible cause of substantial morbidity, failed to translate into a definite survival advantage. We report on interim results of an ongoing Phase II study of regional chemotherapy in terms of isolated thoracic perfusion with chemofiltration (ITP-F).

Patients and methods:

Twenty-eight patients (25 male, 3 female, mean age 63.4 years) with advanced pleural mesothelioma participated in this study. Insertion of a venous and arterial stop-flow balloon catheter via a femoral access allowed to achieve isolation of the chest to perform the ITP-F procedure. The aorta and inferior vena cava were blocked at the level of the diaphragm, and the upper arms were blocked by pneumatic cuffs. Consequently, chemotherapy, consisting of 60 mg/m² cisplatin and 15 mg/m² mitoxantrone, was administered directly into the aorta. The isolated circuit was maintained for 15 minutes followed by ~45 minutes of chemofiltration with a hemoprocessor until 5 L of filtrate were reached. The endpoints of the study were overall survival and quality of life (QoL).


Out of 28 patients enrolled in the study, 5 had prior surgeries, 10 patients had systemic chemotherapy, and 5 patients additional irradiation. In all patients in restaging, there was a notable clinical progress. In all, 162 cycles were administered. Due to chemofiltration, toxicity was within tolerable limits, revealing World Health Organization grade I leucopenia and thrombocytopenia in 9 patients and mucositis grade I in 6 patients. Furthermore, the major surgical complication was inguinal lymphatic fistula in 40% of the cases. Gastrointestinal toxicity and/or neurotoxicity were never observed. One-year survival was 49%, 2-year and 3-year survival was 31%, and 5-year survival was 18%. Median overall survival was 12 months and progression-free survival 9 months.


Therefore, the data shows that ITP-F for patients with advanced pleural mesothelioma, which is still progressive after standard therapies, is an effective treatment modality. It also shows that the patients tolerated the treatment well. Hence, the treatment offers comparably long survival data and good QoL.

To enquire whether you or someone you know, who is fighting progressive malignant pleural mesothelioma, can be a candidate for isolated thoracic perfusion with chemofiltration, kindly fill out a request for information form here. In addition, to read the complete peer reviewed study paper, kindly click here.