Because of regional differences in guidelines and evolving evidence, clinical practices in the treatment of mesothelioma, thymoma, and small cell lung cancer (SCLC) vary globally. During Pro Con Debates on Hot Topics in Mesothelioma, Thymoma, and Small Cell Cancer, a multidisciplinary panel of experts will debate treatment approaches for these rare tumors. The discussion will take place from 08:00–10:00 Korea Standard Time (KST) on Saturday, September 12, in Room 105, Grand Ballroom, 1F.
This session will address three highly debated questions in thoracic surgical oncology:
- Should surgery be used in a multimodal approach to pleural mesothelioma?
- Should neoadjuvant therapy be routinely used in stage III thymoma?
- Should surgery be routinely used in limited-stage SCLC?
Session Co-chair Ritu R. Gill, MD, MPH, Professor of Radiology and Chief of the Division of Cardiothoracic Imaging at Columbia University Vagelos College of Physicians and Surgeons, said clinicians are making these calls in clinic now, often without settled guidance, so this session is especially valuable for them to hear compelling cases from experts globally.
“These decisions should be individualized and grounded in current evidence and multidisciplinary input rather than institutional habit or dogma,” Dr. Gill said. “Hearing how clinicians in different health systems around the world approach the same question is one of the fastest ways to stress-test your own practice.
Pro Con Debates on Hot Topics in Mesothelioma, Thymoma, and Small Cell Cancer
Saturday, September 12, at 08:00 KST • Room 105, Grand Ballroom, 1F
Hear from a multidisciplinary panel of experts who will debate treatment approaches for these rare tumors. LEARN MORE
The MARS2 trial reopened the debate on surgery for mesothelioma, with results demonstrating that patients who had surgery experienced lower survival rates and more severe adverse events. As a result, surgery for mesothelioma is no longer performed in Europe, where the trial took place, leaving systemic therapy as the only treatment option.
However, Session Chair Jeffrey B. Velotta, MD, Surgical Director of the Kaiser Permanente Mesothelioma Program and Clinical Professor at the KP Bernard J. Tyson School of Medicine, questions this change in clinical practice, given how variable mesothelioma surgery is worldwide.
Along with 15 other experts, Dr. Velotta contributed to the Society of Thoracic Surgeons 2026 Expert Consensus on the Multimodal Treatment of Pleural Mesothelioma. The guideline deviates from the trial results, stating that surgery remains an option under special circumstances, but extrapleural pneumonectomy should be avoided.
Neoadjuvant therapy for thymoma has also been the subject of much debate, as there is no international consensus on sequencing therapy for stage III thymoma. Dr. Velotta said current evidence suggests that surgery with chemotherapy is beneficial. However, questions remain about when to do it, which systemic agents to use, and in what order.
Finally, interest in surgical resection for early SCLC—specifically stages T1-T3 N0M0, where N0M0 is a key determinant—is growing despite chemoradiation remaining the default. However, emerging data suggest that surgery may be beneficial for SCLC when it is caught early.
“I want people to know that there are other options besides just the standard of care or what the guidelines recommend, which is basically chemotherapy in a lot of these disease states,” Dr. Velotta said. “There are other multimodal treatment options available that work.”
Please refer to the 2026 WCLC Scientific Program for the most up-to-date schedule information.
