The UK has the highest incidence of mesothelioma in the world, but services vary across the country partly due to uneven geographical distribution of cases. The Mesothelioma UK-funded national organisational audit has highlighted challenges in accessing diagnostic procedures such as thoracoscopy, as well as identifying examples of best practice, including access to clinical trials and specialist therapeutic procedures. To ensure equitable and optimal patient care, cancer alliances should have established referral pathways to specialist multidisciplinary team (MDT) services for discussion of all mesothelioma patients.
Subscribe to Journal
Get full journal access for 1 year
only $20.79 per issue
All prices are NET prices.
VAT will be added later in the checkout.
Rent or Buy article
Get time limited or full article access on ReadCube.
All prices are NET prices.
Cancer Research UK. Mesothelioma Statistics. https://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/mesothelioma. Accessed April 2020.
Royal College of Physicians. National Mesothelioma Audit report 2020 (for the audit period 2016–18). (Royal College of Physicians, London, 2020).
NHS England. 2013/14 NHS STANDARD CONTRACT FOR CANCER: MALIGNANT MESOTHELIOMA (ADULT). (NHS England B10/S/a, 2013).
Vogelzang, N. J., Rusthoven, J. J., Symanowski, J., Denham, C., Kaukel, E., Ruffie, P. et al. Phase III study of pemetrexed in combination with cisplatin versus cisplatin alone in patients with malignant pleural mesothelioma. J. Clin. Oncol. 21, 2636–2644 (2003).
Zalcman, G., Mazieres, J., Margery, J., Greillier, L., Audigier-Valette, C., Moro-Sibilot, D. et al. Bevacizumab for newly diagnosed pleural mesothelioma in the Mesothelioma Avastin Cisplatin Pemetrexed Study (MAPS): a randomised, controlled, open-label, phase 3 trial. Lancet 387, 1405–1414 (2016).
Treasure, T., Lang-Lazdunski, L., Waller, D., Bliss, J. M., Tan, C., Entwisle, J. et al. Extra-pleural pneumonectomy versus no extra-pleural pneumonectomy for patients with malignant pleural mesothelioma: clinical outcomes of the Mesothelioma and Radical Surgery (MARS) randomised feasibility study. Lancet Oncol. 12, 763–772 (2011).
Clive, A. O., Taylor, H., Dobson, L., Wilson, P., de Winton, E., Panakis, N. et al. Prophylactic radiotherapy for the prevention of procedure-tract metastases after surgical and large-bore pleural procedures in malignant pleural mesothelioma (SMART): a multicentre, open-label, phase 3, randomised controlled trial. Lancet Oncol. 17, 1094–1104 (2016).
Bayman, N., Appel, W., Ashcroft, L., Baldwin, D. R., Bates, A., Darlison, L. et al. Prophylactic irradiation of tracts in patients with malignant pleural mesothelioma: an open-label, multicenter, phase III randomized trial. J. Clin. Oncol. 37, 1200–1208 (2019).
Woolhouse, I., Bishop, L., Darlison, L., De Fonseka, D., Edey, A., Edwards, J. et al. British Thoracic Society Guideline for the investigation and management of malignant pleural mesothelioma. Thorax 73, i1–i30 (2018).
Royal College of Physicians, Mesothelioma UK. National Mesothelioma Audit organisational audit report 2019. (Royal College of Physicians, London, 2020).
We thank the Royal College of Physicians and Mesothelioma UK for running and funding the national mesothelioma audits and organisational audit respectively.
Ethics approval and consent to participate
All data within this article is available through the cited references.
The authors declare no competing interests.
None for this invited comment.
Note This work is published under the standard license to publish agreement. After 12 months the work will become freely available and the license terms will switch to a Creative Commons Attribution 4.0 International (CC BY 4.0).
Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
About this article
Cite this article
Harden, S.V., Darlison, L., Beckett, P. et al. Standards of care in mesothelioma treatment. Br J Cancer 123, 1588–1589 (2020). https://doi.org/10.1038/s41416-020-01078-y