The minimum standard of care for managing malignant pleural mesothelioma in developing nations within the Asia‐Pacific Region

Malignant pleural mesothelioma (MPM) is an incurable malignancy associated with high symptom burden and poor prognosis. The relationship between asbestos exposure and MPM incidence is well‐established. The incidence rate of MPM in Australia and New Zealand is among the highest globally. Matching the...

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Bibliographic Details
Published in:Asia-Pacific journal of clinical oncology 2022-06, Vol.18 (3), p.177-190
Main Authors: Ke, Helen, Kao, Steven, Lee, Kenneth, Takahashi, Ken, Goh, Hui Poh, Linton, Anthony
Format: Article
Language:English
Subjects:
Asbestos
Developing Countries
developing nations
Diagnosis
Humans
Immunotherapy
Industrial applications
Latency
Lung Neoplasms - diagnosis
Lung Neoplasms - epidemiology
Lung Neoplasms - therapy
Malignancy
malignant pleural mesothelioma
Medical prognosis
Mesothelioma
Mesothelioma - epidemiology
Mesothelioma - therapy
Mesothelioma, Malignant
Occupational diseases
Pleural Neoplasms - epidemiology
Pleural Neoplasms - therapy
Standard of Care
Symptom management
treatment
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Summary:Malignant pleural mesothelioma (MPM) is an incurable malignancy associated with high symptom burden and poor prognosis. The relationship between asbestos exposure and MPM incidence is well‐established. The incidence rate of MPM in Australia and New Zealand is among the highest globally. Matching the experience of other nations with legal restrictions on asbestos, incidence is expected to fall. In contrast, the incidence of MPM is rising in the developing nations of the Asia‐Pacific as consumption and mining (albeit to a lesser extent) of asbestos continues. The incidence of MPM in these nations is currently low or unknown, reflecting insufficient latency periods since industrial use of asbestos, deficient resources for accurate diagnosis, and lack of occupational disease or cancer registries. The landscape of treatment for MPM is rapidly changing with combination immunotherapy now demonstrating improved survival in the first‐line setting. Considering vast global inequity in access to anticancer treatments, establishing minimum standard of care for MPM in developing nations is of greater significance. Here, we review the evidence that form the basis of our minimum‐standard recommendations for diagnosis, systemic treatment, management of recurrent pleural effusions, and symptom management. We also briefly review evidence‐based treatment that may be considered for those with access.
ISSN:1743-7555
1743-7563
DOI:10.1111/ajco.13611