New Era for Malignant Pleural Mesothelioma

Updates on Therapeutic Options

Anne S. Tsao, MD, MBA; Harvey I. Pass, MD; Andreas Rimner, MD; Aaron S. Mansfield, MD


J Clin Oncol. 2022;40(6):681-692. 

In This Article

Tumor Response Recording

To standardize tumor response measurements among mesothelioma trials, considering the complex geometry of the disease, modified RECIST (mRECIST) Guidelines have been validated and adopted.[19] Briefly, the most prominent CT sections have tumor thickness measured at those sites from the outer tumor margin to the inner margin in the appropriate direction that captures tumor direction. These measurements are performed at baseline for up to six pleural measurements with no more than two sites per CT section across sections separated by at least 1 cm. A complete response is disappearance of all pleural and nonpleural diseases, whereas a partial response is a summed measurement decrease by 30% or more at baseline, and progressive disease is a summed measurement increase by at least 20%. Considering the acceleration of studies in the use of immunotherapy in mesothelioma, modification of the immune RECIST criteria[33] and interpretations of fluorodeoxyglucose positron emission tomography-CT will be necessary.[34]