Volume 371, Issue 9625, Pages (May 2008)

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Volume 371, Issue 9625, Pages 1685-1694 (May 2008) Active symptom control with or without chemotherapy in the treatment of patients with malignant pleural mesothelioma (MS01): a multicentre randomised trial Martin F Muers, FRCP, Richard J Stephens, Patricia Fisher, FRCR, Liz Darlison, BSc Hons, Christopher MB Higgs, MD, Erica Lowry, BA, Prof Andrew G Nicholson, DM, Mary O'Brien, MD, Michael Peake, FRCP, Robin Rudd, MD, Michael Snee, DM, Jeremy Steele, MD, David J Girling, FRCP, Matthew Nankivell, MSc, Cheryl Pugh, BSc Hons, Prof Mahesh KB Parmar, DPhil The Lancet Volume 371, Issue 9625, Pages 1685-1694 (May 2008) DOI: 10.1016/S0140-6736(08)60727-8 Copyright © 2008 Elsevier Ltd Terms and Conditions

Figure 1 Trial profile After 3 years accrual, the trial design was changed to a two-group comparison by combining the two chemotherapy groups. The three-way randomisation was retained to allow some exploratory analyses of the two different chemotherapy groups. ASC=active symptom control. MVP=mitomycin, vinblastine, and cisplatin. V=vinorelbine. The Lancet 2008 371, 1685-1694DOI: (10.1016/S0140-6736(08)60727-8) Copyright © 2008 Elsevier Ltd Terms and Conditions

Figure 2 Clinicians assessment of symptoms and side-effects (A) Proportion of patients with moderate or severe chest pain. (B) Proportion of patients with moderate or severe lethargy. Error bars indicate 95% CIs. ASC=active symptom control. MVP=mitomycin, vinblastine, and cisplatin. V=vinorelbine. The Lancet 2008 371, 1685-1694DOI: (10.1016/S0140-6736(08)60727-8) Copyright © 2008 Elsevier Ltd Terms and Conditions

Figure 3 Mean standardised scores for the four predefined quality-of-life endpoints (A) Physical functioning; (B) pain; (C) dyspnoea; and (D) global quality of life. Error bars indicate 95% CIs. ASC=active symptom control. MVP=mitomycin, vinblastine, and cisplatin. V=vinorelbine. The Lancet 2008 371, 1685-1694DOI: (10.1016/S0140-6736(08)60727-8) Copyright © 2008 Elsevier Ltd Terms and Conditions

Figure 4 Overall survival (A) Two-group comparison: ASC vs ASC plus chemotherapy. (B) Three-group comparison: ASC vs ASC plus MVP vs ASC plus vinorelbine. ASC=active symptom control. MVP=mitomycin, vinblastine, and cisplatin. V=vinorelbine. CT=chemotherapy. The Lancet 2008 371, 1685-1694DOI: (10.1016/S0140-6736(08)60727-8) Copyright © 2008 Elsevier Ltd Terms and Conditions

Figure 5 Progression-free survival ASC=active symptom control. MVP=mitomycin, vinblastine, and cisplatin. V=vinorelbine. The Lancet 2008 371, 1685-1694DOI: (10.1016/S0140-6736(08)60727-8) Copyright © 2008 Elsevier Ltd Terms and Conditions