Abstract
Malignant mesothelioma is an aggressive form of cancer affecting the pleura and the serous membranes. Asbestos exposure is the most important factor contributing to the development of malignant mesothelioma. Malignant pleural mesothelioma in general has poor prognosis with studies suggesting that without treatment the median survival is between 4 to 12 months. Unfortunately, there are not many therapeutic interventions that can be offered to patients with malignant mesothelioma. In recent years, another approach that centers on the cancer immune response has shown promising results in managing certain types of tumors including malignant mesothelioma. In addition, to Pembrolizumab there are other immunotherapy agents currently under investigation for the potential future treatment options for patients with malignant mesothelioma. The new approaches using immunotherapy to manage patients with malignant pleural mesothelioma are encouraging. However, more evidence is still required before immunotherapy becomes acceptable form of treatment for malignant pleural mesothelioma.
Highlights
Malignant mesothelioma is an aggressive form of cancer affecting the pleura and the serous membranes [1,2]
A recent MesoVATS study showed that there was no difference in overall survival between patients with malignant mesothelioma undergoing medical pleurodesis or surgical Videoassisted thoracoscopic surgery (VATS) partial pleurectomy with the former having shorter hospital stay and fewer complications [9]
Doxorubicin can be used as a second line treatment of malignant mesothelioma for recurrence with studies showing 16% response and a median survival for those with response of 16.7 months [7,20]
Summary
Malignant mesothelioma is an aggressive form of cancer affecting the pleura and the serous membranes [1,2]. A recommended combination of Pemetrexed and Cisplatin has been used as the first line chemotherapy for patients with malignant mesothelioma. Carboplatin, which is a platinum based drug like Cisplatin and can be used in combination with Pemetrexed for treatment of malignant mesothelioma [16,17]. Doxorubicin can be used as a second line treatment of malignant mesothelioma for recurrence with studies showing 16% response and a median survival for those with response of 16.7 months [7,20]. Amatuximab, which is a chimeric monoclonal antibody to mesothelin, a cell surface glycoprotein highly expressed in malignant pleural mesothelioma, in combination with Pemetrexed and Cisplatin was assessed in patients with malignant mesothelioma and was shown to be well tolerated but the progression free survival was no different with historical data with median overall survival of 14.8 months [22]
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