A randomised phase II study of extended pleurectomy/decortication preceded or followed by chemotherapy in patients with early-stage pleural mesothelioma: EORTC 1205 Article Swipe
Jo Raskin
,
Veerle Surmont
,
Alexander P.W.M. Maat
,
Maha Yahia
,
Sjaak A. Burgers
,
Yassin Pretzenbacher
,
Frédéric De Ryck
,
Robin Cornelissen
,
Houke M. Klomp
,
Ana Oliveira
,
Joachim Aerts
,
Paul Baas
,
Sandrine Marréaud
,
Jan P. van Meerbeeck
,
Paul Van Schil
·
YOU?
·
· 2024
· Open Access
·
· DOI: https://doi.org/10.1183/13993003.02114-2023
YOU?
·
· 2024
· Open Access
·
· DOI: https://doi.org/10.1183/13993003.02114-2023
Background The role of surgery in pleural mesothelioma remains controversial. It may be appropriate in highly selected patients as part of a multimodality treatment including chemotherapy. Recent years have seen a shift from extrapleural pleuropneumonectomy toward extended pleurectomy/decortication. The most optimal sequence of surgery and chemotherapy remains unknown. Methods EORTC-1205-LCG was a multicentric, noncomparative phase 2 trial, 1:1 randomising between immediate (arm A) and deferred surgery (arm B), followed or preceded by chemotherapy. Eligible patients (Eastern Cooperative Oncology Group 0–1) had treatment-naïve, borderline resectable T1–3 N0–1 M0 mesothelioma of any histology. Primary outcome was rate of success at 20 weeks, a composite end-point including 1) successfully completing both treatments within 20 weeks; 2) being alive with no signs of progressive disease; and 3) no residual grade 3–4 toxicity. Secondary end-points were toxicity, overall survival, progression-free survival and process indicators of surgical quality. Findings 69 patients were included in this trial. 56 (81%) patients completed three cycles of chemotherapy and 58 (84%) patients underwent surgery. Of the 64 patients in the primary analysis, 21 out of 30 patients in arm A (70.0%; 80% CI 56.8–81.0%) and 17 out of 34 patients (50.0%; 80% CI 37.8–62.2%) in arm B reached the statistical end-point for rate of success. Median progression-free survival and overall survival were 10.8 (95% CI 8.5–17.2) months and 27.1 (95% CI 22.6–64.3) months in arm A, and 8.0 (95% CI 7.2–21.9) months and 33.8 (95% CI 23.8–44.6) months in arm B. Macroscopic complete resection was obtained in 82.8% of patients. 30- and 90-day mortality were both 1.7%. No new safety signals were found, but treatment-related morbidity was high. Interpretation EORTC 1205 did not succeed in selecting a preferred sequence of pre- or post-operative chemotherapy. Either procedure is feasible with a low mortality, albeit consistent morbidity. A shared informed decision between surgeon and patient remains essential.
Related Topics
Concepts
Medicine
Decortication
Mesothelioma
Clinical endpoint
Extrapleural Pneumonectomy
Surgery
Chemotherapy
Pleurectomy
Chemotherapy regimen
Peritoneal mesothelioma
Internal medicine
Pneumonectomy
Lung cancer
Randomized controlled trial
Pathology
Metadata
- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.1183/13993003.02114-2023
- OA Status
- green
- Cited By
- 17
- References
- 27
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W4399412554
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
-
https://openalex.org/W4399412554Canonical identifier for this work in OpenAlex
- DOI
-
https://doi.org/10.1183/13993003.02114-2023Digital Object Identifier
- Title
-
A randomised phase II study of extended pleurectomy/decortication preceded or followed by chemotherapy in patients with early-stage pleural mesothelioma: EORTC 1205Work title
- Type
-
articleOpenAlex work type
- Language
-
enPrimary language
- Publication year
-
2024Year of publication
- Publication date
-
2024-06-01Full publication date if available
- Authors
-
Jo Raskin, Veerle Surmont, Alexander P.W.M. Maat, Maha Yahia, Sjaak A. Burgers, Yassin Pretzenbacher, Frédéric De Ryck, Robin Cornelissen, Houke M. Klomp, Ana Oliveira, Joachim Aerts, Paul Baas, Sandrine Marréaud, Jan P. van Meerbeeck, Paul Van SchilList of authors in order
- Landing page
-
https://doi.org/10.1183/13993003.02114-2023Publisher landing page
- Open access
-
YesWhether a free full text is available
- OA status
-
greenOpen access status per OpenAlex
- OA URL
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https://biblio.ugent.be/publication/01JKTDZ16JZ6VZMW3RP376Y18VDirect OA link when available
- Concepts
-
Medicine, Decortication, Mesothelioma, Clinical endpoint, Extrapleural Pneumonectomy, Surgery, Chemotherapy, Pleurectomy, Chemotherapy regimen, Peritoneal mesothelioma, Internal medicine, Pneumonectomy, Lung cancer, Randomized controlled trial, PathologyTop concepts (fields/topics) attached by OpenAlex
- Cited by
-
17Total citation count in OpenAlex
- Citations by year (recent)
-
2025: 12, 2024: 5Per-year citation counts (last 5 years)
- References (count)
-
27Number of works referenced by this work
- Related works (count)
-
10Other works algorithmically related by OpenAlex
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