Top Line: Is surgery more trouble than it’s worth for mesothelioma?
The Study: Results of the large prospective Mesothelioma and Radical Surgery 2 (MARS 2) trial were presented last week at the 2023 World Conference on Lung Cancer. It randomized 335 patients receiving first-line chemotherapy for “resectable” mesothelioma to +/- the addition of pleurectomy decortication. From the outset, it’s clear these surgeries are no joke and have a small chance of microscopically complete resection—thus the chemo backbone—but this is the first trial to prospectively assess its utility. While the primary endpoint of median overall survival was not statistically different, the media buzz is focusing on a significant detriment in survival in the first 3.5 years after surgery (HR 0.72). Surgery also resulted in a >3-fold increase in serious adverse events, worse quality of life, and increased costs.
TBL: The best data we have on the subject suggests more cons than pros with surgery for mesothelioma. | Gebhart, ILCN 2023
The Study: Results of the large prospective Mesothelioma and Radical Surgery 2 (MARS 2) trial were presented last week at the 2023 World Conference on Lung Cancer. It randomized 335 patients receiving first-line chemotherapy for “resectable” mesothelioma to +/- the addition of pleurectomy decortication. From the outset, it’s clear these surgeries are no joke and have a small chance of microscopically complete resection—thus the chemo backbone—but this is the first trial to prospectively assess its utility. While the primary endpoint of median overall survival was not statistically different, the media buzz is focusing on a significant detriment in survival in the first 3.5 years after surgery (HR 0.72). Surgery also resulted in a >3-fold increase in serious adverse events, worse quality of life, and increased costs.
TBL: The best data we have on the subject suggests more cons than pros with surgery for mesothelioma. | Gebhart, ILCN 2023