2024 World Conference on Lung Cancer (WCLC) - ePosters-EP.14A.20 Hyperthermic Intrathoracic Chemotherapy Following Cytoreductive Surgery in Patients with Pleural Mesothelioma

EP.14A.20 Hyperthermic Intrathoracic Chemotherapy Following Cytoreductive Surgery in Patients with Pleural Mesothelioma

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Hyperthermic intrathoracic chemotherapy (HITOC) is a treatment used following cytoreductive surgery for patients with malignant pleural mesothelioma (MPM). HITOC has demonstrated a significant survival benefit when combined with surgery and systemic chemotherapy, particularly in epithelioid subtype cases. Some common complications associated with the procedure include atrial fibrillation and renal toxicity, but overall, HITOC shows fewer complications compared to systemic chemotherapy alone.<br /><br />The HITOC procedure is performed after cytoreductive surgery, such as pleurectomy/decortication, extended pleurectomy/decortication, or extrapleural pneumonectomy. The chemotherapeutic agent primarily used is cisplatin, which may be combined with doxorubicin. The procedure usually runs for 60 minutes at 42°C to enhance tissue perfusion.<br /><br />Several studies have reported various outcomes with HITOC. For instance, Rusch et al. (1994) and Sugarbaker et al. (1997, 2013) recorded survival benefits with this treatment. More recent studies by Burt et al. (2018), Elliot et al. (2023), and Klotz et al. (2024) continue to support these results, although outcomes vary depending on study parameters and patient demographics.<br /><br />A case series from the University of Miami highlighted that HITOC, combined with systemic treatments like cisplatin/pemetrexed and immunotherapies, resulted in a median survival of 17.5 months and a median progression-free survival (PFS) of 10 months, with 50% operative morbidity but 0% operative mortality. <br /><br />In conclusion, while HITOC is well tolerated and offers significant benefits when integrated into a multimodal treatment strategy, there remains variability in outcomes across studies. Further research is needed to establish optimal protocols and treatment regimens to maximize its effectiveness.

Asset Subtitle

Gavin Stoel

Meta Tag

Speaker Gavin Stoel

Topic Mesothelioma, Thymoma, and Other Thoracic Tumors

Keywords

Hyperthermic intrathoracic chemotherapy

HITOC

malignant pleural mesothelioma

cytoreductive surgery

epithelioid subtype

cisplatin

survival benefit

atrial fibrillation

renal toxicity

systemic chemotherapy