Prognosis of patients with malignant pleural mesothelioma remains very poor. Single treatment modality is clearly not effective in improving disease-free and overall survival. For this reason combined modality therapy is intensively investigated. In the well-performed and timely systematic review by Cao and colleagues, results of trimodality therapy for mesothelioma consisting of neoadjuvant or adjuvant chemotherapy, extrapleural pneumonectomy and adjuvant radiotherapy, were evaluated (1).