The Evolving Therapeutic Landscape for Malignant Pleural Mesothelioma

Curr Oncol Rep. 2022 Nov;24(11):1413-1423. doi: 10.1007/s11912-022-01302-3. Epub 2022 Jun 3.

Abstract

Purpose of review: For patients with malignant pleural mesothelioma, prognosis is poor with extremely low 5-year survival rates and limited therapeutic options. Here, we review the current treatment landscape for mesothelioma and highlight promising future therapeutic directions.

Recent findings: Evolving frontline therapeutic options for mesothelioma include VEGF inhibition in combination with chemotherapy and dual immune checkpoint inhibition, with synergisms between the therapies and response prediction via biomarkers also being explored. Evolving experimental treatments for mesothelioma include PARP and ALK inhibitors, dendritic and CAR T-cell therapies, anti-mesothelin vaccines, and oncolytic viral therapies, representing timely advances in the field. The therapeutic landscape for malignant pleural mesothelioma is evolving and preferred treatment in the frontline and later settings will likely evolve with it. However, this does not preclude the evidence for including multi-modal therapies spanning angiogenesis and immune checkpoint inhibitors, and biomarker utilization, in current clinical trials and management.

Keywords: CAR T-cell therapy; Genetic targets; Immunotherapy; Malignant pleural mesothelioma; Mesothelioma biomarkers; VEGF inhibition.

Publication types

  • Review

MeSH terms

  • Humans
  • Immune Checkpoint Inhibitors
  • Immunotherapy
  • Lung Neoplasms* / drug therapy
  • Mesothelioma* / drug therapy
  • Mesothelioma* / pathology
  • Mesothelioma, Malignant*
  • Pleural Neoplasms* / drug therapy
  • Pleural Neoplasms* / pathology
  • Poly(ADP-ribose) Polymerase Inhibitors / therapeutic use
  • Receptor Protein-Tyrosine Kinases
  • Vascular Endothelial Growth Factor A

Substances

  • Immune Checkpoint Inhibitors
  • Poly(ADP-ribose) Polymerase Inhibitors
  • Vascular Endothelial Growth Factor A
  • Receptor Protein-Tyrosine Kinases