Lee Moffitt Cancer Center And Research Institute/United States Of America, 17Hematology/Oncology, University Of Pittsburgh/United States Of America, 18Medical University Of South Carolina/United States Of America, 19Georgetown University, Lombardi Comprehensive Cancer Center/United States Of America, 20Hamon Center For Therapeutic Oncology Research And The Simmons Comprehensive Cancer Center, University Of Texas Southwestern Medical Center At Dallas/United States Of America, 21Medical Oncology, University Of Colorado Denver-AMS/United States Of AmericaĪbstract: The single most important advance in the approach to lung cancer treatment in the past decade has been the iterative identification and targeting of subsets of lung cancer defined by distinct oncogenic driver mutations.
Simmons Cancer Center, UT Southwestern Medical Center/United States Of America, 16Thoracic Oncology, H. Of Medicine/division Of Hematology-Oncology, Vanderbilt University/United States Of America, 14Johns Hopkins/United States Of America, 15Harold C. Medicine/United States Of America, 9University Of Colorado Cancer Center/United States Of America, 10University Of Texas, MD Anderson Cancer Center/United States Of America, 11Emory University/United States Of America, 12David Geffen School Of Medicine, Ucla/United States Of America, 13Dept. Ethical approval was granted by Huntingdon, Cambridge (UK) Research Ethics committee: H02/809 ISRCTN: 34321019 NCT00821860. A total of 196 patients was required to show a survival difference at 1 year of 59% (VAT pleurectomy) versus 37% (talc pleurodesis). VAT pleurectomy involved partial parietal pleurectomy and decortication of the visceral pleura, where appropriate, to achieve lung re-expansion. Talc pleurodesis was performed via tube thoracostomy or by poudrage at thoracoscopy. Participants were risk stratified using a modified EORTC prognostic scoring system. Previous malignancy was permitted if there was no evidence of active disease and MPM had been confirmed. Exclusion criteria included previous pleurodesis by any approach. Methods: A multicentre randomised controlled trial of VAT pleurectomy versus talc pleurodesis was undertaken for patients > 18 years with any sub-type confirmed or suspected MPM with a pleural effusion who were fit enough to undergo VAT pleurectomy.
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