Thus far, when discussing malignant pleural mesothelioma (MPM), a cancer of the normally onion skin-like lining around the lung, I’ve primarily talked about the role of chemotherapy.

So far, I've only written a few introductory posts on mesothelioma, but there were some interesting presentations at ASCO 2007 about the topic. One described the results of an expanded access protocol (EAP), which is when a company gives free access to a drug that is not yet commercially available (generally in exchange for participation in a data-collection study).

For many years, patients with malignant pleural mesothelioma (MPM) were often not offered treatment. Surgery was offered to rare, selected patients who tended to be much younger and more fit than a typical patient with MPM, but we'll talk about surgery later. Chemotherapy was only very inconsistently offered to the vast majority of unresectable patients with MPM, because it was not felt to clearly be beneficial. This is pretty similar to the view of advanced NSCLC until the mid- to late-1990s.

We haven't covered this on OncTalk yet, but it's a real shortcoming that I haven't discussed malignant pleural mesothelioma (MPM). Although it's not exactly lung cancer, it's another chest cancer that is often managed by thoracic oncology specialists like myself, and the only reason I haven't introduced it until now is that it's such an unusual cancer, accounting for just 2000-3000 cases each year in the US.