A randomised trial of active symptom control with or without chemotherapy in patients with malignant pleural mesothelioma

Can we run a big trial to look at treatments for mesothelioma?

What was this study about?

Malignant pleural mesothelioma (MPM) is a very deadly form of lung cancer brought on by exposure to asbestos. Asbestos used to be widely used in building and manufacturing, because of its resistance to heat, electricity and chemical damage. But more recently it has been banned as a potential health hazard. Although rates of MPM are peaking in North America and Western Europe as a result of the bans introduced on its use and increased health and safety measures, worldwide incidence of the disease continues to rise.

There were nearly 2000 mesothelioma deaths in the UK in 2005. This yearly death rate is expected to increase.

Guidance produced for doctors on the treatment of mesothelioma recommended active symptom control. This means that if people experience symptoms (for example breathlessness or difficulty in breathing), doctors will try to treat the symptoms using a variety of therapies. But up to this point there had been no trials that compared active symptom control with chemotherapy. The MESO-1 trial had two key aims:

  • To see if it would be possible to run a trial to compare active symptom control with chemotherapy – would it be acceptable to patients?
  • To test the suitability of two standard quality of life questionnaires for mesothelioma.

What difference did this study make?

This feasibility study found that it would be possible to run a trial to compare active symptom control alone with active symptom control and chemotherapy. One quality of life questionnaire, the called the EORTC Quality of Life Questionnaire, was found to be best to look at people’s quality of life.

This small feasibility study enabled researchers to plan a larger study, called MS01.

Type of study

Randomised trial

Contact details

When did it take place?

This trial recruited patients between 2000 and 2001. The results of the trial were published in 2004.

Who was included?

52 people with mesothelioma from 20 centres took part in this trial.