New Concepts in the Treatment of Malignant Pleural Mesothelioma

Annu Rev Med. 2018 Jan 29:69:365-377. doi: 10.1146/annurev-med-041316-085813. Epub 2017 Oct 13.

Abstract

Malignant pleural mesothelioma (MPM) is a highly aggressive and generally incurable cancer. Current anti-MPM chemotherapy-based treatments are only marginally effective, and long-term survival remains an unmet goal. Nonetheless, in selected cases, personalized surgery-based multimodality treatments (MMT) have been shown to significantly extend survival. The design of MMT and selection of patients are challenging, and optimal results require accurate presurgical diagnosis, staging, and risk stratification. Further, meticulous surgical techniques and advanced radiation protocols must be applied. We review key principles and evolving concepts in the care of MPM patients with a focus on the expanding role of MMT in MPM.

Keywords: cytoreduction; immunotherapy; mesothelioma; surgery.

Publication types

  • Review

MeSH terms

  • Angiogenesis Inhibitors / therapeutic use
  • Antineoplastic Agents, Immunological / therapeutic use
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Chemotherapy, Adjuvant
  • Combined Modality Therapy
  • Humans
  • Lung Neoplasms / therapy*
  • Maintenance Chemotherapy
  • Mesothelioma / therapy*
  • Mesothelioma, Malignant
  • Neoadjuvant Therapy
  • Neoplasm Staging
  • Pleural Neoplasms / therapy*
  • Radiotherapy / methods*
  • Radiotherapy, Adjuvant
  • Radiotherapy, Intensity-Modulated / methods
  • Risk Assessment
  • Thoracic Surgical Procedures / methods*

Substances

  • Angiogenesis Inhibitors
  • Antineoplastic Agents, Immunological