Bevacizumab in pleural mesothelioma: too few, too late?

The French Cooperative Thoracic Intergroup recently reported the mature results of its Mesothelioma Avastin Cisplatin Pemetrexed Study (MAPS) (1). The investigators are to be commended for the outstanding design, conduct and analysis of this investigator initiated trial, which they claim will lead to a much needed improvement in the treatment paradigm for this dreadful disease. Let’s review the reported evidence and address its internal and external validity.