{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,13]],"date-time":"2025-11-13T12:11:44Z","timestamp":1763035904717},"reference-count":34,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"17","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCO"],"published-print":{"date-parts":[[2004,9,1]]},"abstract":"<jats:sec><jats:title>Purpose<\/jats:title><jats:p> To investigate neoadjuvant chemotherapy with cisplatin and gemcitabine followed by extrapleural pneumonectomy with or without radiation therapy in patients with potentially resectable malignant pleural mesothelioma (MPM). <\/jats:p><\/jats:sec><jats:sec><jats:title>Patients and Methods<\/jats:title><jats:p> Eligible patients had MPM with clinical stage T1-3, N0-2, M0 disease considered to be completely resectable and a WHO performance status of 0 to 2. Neoadjuvant chemotherapy consisted of three cycles of cisplatin 80 mg\/m<jats:sup>2<\/jats:sup> on day 1 and gemcitabine 1,000 mg\/m<jats:sup>2<\/jats:sup> on days 1, 8, and 15, given every 28 days. Surgery had to consist of a complete extrapleural pneumonectomy, including resection of pericardium and diaphragm. Postoperative radiotherapy was to be considered for all patients. <\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p> Nineteen patients with MPM were included in this pilot study. According to the European Organization for Research and Treatment of Cancer prognostic score, two patients were in the good prognosis group, and 17 patients were in the poor prognosis group. The response rate to neoadjuvant chemotherapy was 32%. The major toxicity was thrombocytopenia. Extrapleural pneumonectomy was performed in 16 patients with no perioperative mortality. Major surgical complications occurred in six patients, and all were treated successfully. Thirteen patients received postoperative radiotherapy. The median survival time was 23 months. Two patients remain alive and free of disease 41 and 38 months after initiation of therapy. <\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p> For patients with potentially operable MPM, the availability of active and well-tolerated chemotherapy regimens, the fact that extrapleural pneumonectomy can be safely performed after neoadjuvant chemotherapy in an experienced center, and the promising results regarding survival in our pilot study warrant further investigation of the role of neoadjuvant chemotherapy in a multimodality strategy. <\/jats:p><\/jats:sec>","DOI":"10.1200\/jco.2004.10.071","type":"journal-article","created":{"date-parts":[[2004,8,30]],"date-time":"2004-08-30T22:33:03Z","timestamp":1093905183000},"page":"3451-3457","source":"Crossref","is-referenced-by-count":195,"title":["Neoadjuvant Chemotherapy Followed by Extrapleural Pneumonectomy in Malignant Pleural Mesothelioma"],"prefix":"10.1200","volume":"22","author":[{"given":"Walter","family":"Weder","sequence":"first","affiliation":[{"name":"From the Division of Thoracic Surgery, Clinic and Policlinic for Radiation Oncology, and Clinic and Policlinic for Oncology, University Hospital, Zurich, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"Kestenholz","sequence":"additional","affiliation":[{"name":"From the Division of Thoracic Surgery, Clinic and Policlinic for Radiation Oncology, and Clinic and Policlinic for Oncology, University Hospital, Zurich, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christian","family":"Taverna","sequence":"additional","affiliation":[{"name":"From the Division of Thoracic Surgery, Clinic and Policlinic for Radiation Oncology, and Clinic and Policlinic for Oncology, University Hospital, Zurich, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefan","family":"Bodis","sequence":"additional","affiliation":[{"name":"From the Division of Thoracic Surgery, Clinic and Policlinic for Radiation Oncology, and Clinic and Policlinic for Oncology, University Hospital, Zurich, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Didier","family":"Lardinois","sequence":"additional","affiliation":[{"name":"From the Division of Thoracic Surgery, Clinic and Policlinic for Radiation Oncology, and Clinic and Policlinic for Oncology, University Hospital, Zurich, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Monika","family":"Jerman","sequence":"additional","affiliation":[{"name":"From the Division of Thoracic Surgery, Clinic and Policlinic for Radiation Oncology, and Clinic and Policlinic for Oncology, University Hospital, Zurich, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rolf A.","family":"Stahel","sequence":"additional","affiliation":[{"name":"From the Division of Thoracic Surgery, Clinic and Policlinic for Radiation Oncology, and Clinic and Policlinic for Oncology, University Hospital, Zurich, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"233","reference":[{"key":"R1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.103.4_Supplement.377S"},{"key":"R2","doi-asserted-by":"publisher","DOI":"10.1136\/thx.31.1.15"},{"key":"R3","doi-asserted-by":"crossref","unstructured":"Rusch VW: Trials in malignant mesothelioma: Lcsg-851 and Lcsg-882. 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