The potential value of immunotherapy, individualized chemotherapy, second-line treatments, and strategies for patient monitoring are among the top ten priorities for mesothelioma research according to British patients, caregivers, and clinicians.
The James Lind Alliance specializes in setting priorities for health policy. The group was asked to work with the British National Institute for Health Research to study mesothelioma in the wake of sweeping mesothelioma compensation legislation in 2013. The Priority Setting Partnership brought together mesothelioma patients, caregivers, clinicians and support organizations to develop a research priority list, which was published in the latest issue of Lung Cancer.
In all, 453 of the initial mesothelioma surveys were returned and refined into 52 unanswered research questions. Another 202 responders helped reduce that list of 52 down to 30 questions which were then taken to a final meeting where mesothelioma patients, caregivers and health professionals decided together on the top ten.
According to the group, the top ten mesothelioma research questions are:
- Does immunotherapy improve mesothelioma response and survival?
- What factors can predict response to individualized chemotherapy?
- How should patients with pleural thickening (but no mesothelioma) be monitored?
- What is the best second-line treatment?
- What is the best way to treat fluid buildup in the abdomen of peritoneal mesothelioma patients?
- What are the benefits of immediate chemotherapy compared to watching and waiting?
- What is the best follow-up strategy?
- Can immunotherapy boost the effectiveness of other treatments?
- Will annual CT scans lead to earlier mesothelioma diagnosis?
- How does lung-sparing surgery compare with no surgery and which patients benefit most?
The group added three “bonus questions” on the role of PET-CT in mesothelioma diagnosis, the diagnostic and prognostic value of the protein mesothelin, and the best treatment for shortness of breath.
“This list is an invaluable resource, which should be used to inform the prioritization and funding of future mesothelioma research,” writes Richard J. Stephens of the Institute of Clinical Trials & Methodology, a member of the Priority Setting Partnership.
The UK has one of the highest per capita rates of mesothelioma in the world and incidence is continuing to rise.
Stephens, RJ, et al, “Research priorities in mesothelioma: A James Lind Alliance Priority Setting Partnership”, June 4, 2015, Lung Cancer, Epub ahead of print