Abstract
Malignant pleural mesothelioma (MPM) is a rare, aggressive cancer of the lung lining that is predominantly associated with occupational exposure to asbestos. MPM is responsible for thousands of deaths worldwide every year, with the median survival of MPM of 8–14 months. There are limited biomarkers available in the clinic to effectively diagnose MPM, an invasive biopsy procedure is usually required to provide a definitive diagnosis. Due to the long latency period associated with MPM disease presentation, the cancer is usually at an advanced stage at the time of diagnosis where treatment options are largely ineffective at controlling disease progression. Previous MPM-based pre-clinical studies have made significant strides in determining the exact molecular mechanisms associated with asbestos carcinogenesis. Exploring less invasive blood-based biomarkers and treatment strategies involving targeted therapy, immunotherapy, and virotherapy is particularly important. Research in these areas is of crucial importance in relation to improving the rate of novel diagnostic biomarkers and treatment strategies progressing through to clinical trials and ultimately into the clinical setting. This review comprehensively summarises both previous and current pre-clinical research developments that have specifically contributed to an improved understanding of MPM disease biology, and the development of novel diagnostic biomarkers and treatment strategies.
Highlights
This article is an open access articleMalignant pleural mesothelioma (MPM) is a rare, highly aggressive, and incurable cancer of the mesothelium lining the pleural surface of the lungs as a consequence of past exposure to the carcinogen, asbestos
Alternative pre-clinical studies have focused on the development of innovative MPM-specific treatment strategies, with promising advancements having been made in areas such as targeted therapy, immunotherapy, and virotherapy
These studies have primarily focused on elucidating the chronic inflammatory processes that lead to MPM pathogenesis, as well as the subsequent or predisposing genetic and molecular alterations that lead to disease progression; including alterations to tumour suppressor genes and oncogenes that are unique to MPM tumours
Summary
Anatomical Pathology Department, NSW Health Pathology, Concord Repatriation General Hospital, Sydney, NSW 2139, Australia. Simple Summary: Malignant pleural mesothelioma (MPM) is an aggressive cancer of the lung lining that is associated with asbestos exposure. Due to a lack of effective biomarkers coupled with a long latency period from asbestos exposure to cancer development, prognosis of MPM is poor with an average survival of 8–14 months following diagnosis. Pre-clinical investigations aimed to develop novel biomarkers and treatment strategies are urgently needed to improve MPM diagnosis and treatments available to MPM patients. Novel protein and microRNA biomarkers constitute promising diagnostic biomarkers of MPM; and treatment strategies such as targeted-, immuneand viro-therapy exhibit promising efficacy. We have provided a comprehensive overview of significant pre-clinical research advancements relating to MPM biology, and biomarker and treatment development for MPM. Advancements Relating to Improving the Diagnosis and Treatment of Malignant Pleural Mesothelioma: A. Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affil-
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