Abstract
Mesothelioma is a rare and aggressive tumour with dismal prognosis arising in the pleura and associated with asbestos exposure. Its incidence is on the rise worldwide. In selected patients with early-stage MPM, a maximal surgical cytoreduction in combination with additional antitumour treatment may be considered in selected patients assessed by a multidisciplinary tumor board. In patients with unresectable or advanced MPM, chemotherapy with platinum plus pemetrexed is the standard of care. Currently, no standard salvage therapy has been approved yet, but second-line chemotherapy with vinorelbine or gemcitabine is commonly used. Novel therapeutic approaches based on dual immunotherapy or chemotherapy plus immunotherapy demonstrated promising survival benefit and will probably be incorporated in the future.
Highlights
Mesothelioma is an uncommon but aggressive and highly lethal malignant tumor arising from the serous membranes, being malignant pleural mesothelioma (MPM) the most common entity
According to the World Health Organization (WHO), about 125 million people worldwide are exposed to asbestos at their workplaces, and every year more than 107,000 workers die from asbestos-related diseases [1]
Studies based on large-scale genomic analysis have identified molecular subtypes and genetic alterations that may be actionable in the future, but genomic studies are not recommended in routine clinical practice [IIIB]
Summary
Mesothelioma is an uncommon but aggressive and highly lethal malignant tumor arising from the serous membranes, being malignant pleural mesothelioma (MPM) the most common entity. According to the World Health Organization (WHO), about 125 million people worldwide are exposed to asbestos at their workplaces, and every year more than 107,000 workers die from asbestos-related diseases [1]. Asbestos were banned by the European Union in 2005, due to the long latency period (usually 20–50 years) among asbestos exposure and MPM diagnosis, the incidence of MPM will peak in Western Europe during the years. Given this broad interval, banning of manufacture, import or industrial use of asbestos will show benefits in the long term. In Spain, asbestos were banned in 2002, but MPM-related deaths will not start to decline in the decade, despite a discreet lowering in tendency of male mortality from 2001 to 2005, with an expected actual rate of 264 deaths/year [2]
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