Malignant Pleural Mesothelioma: An Update on Diagnosis and Treatment Options

Ther Adv Respir Dis. 2016 Jun;10(3):275-88. doi: 10.1177/1753465816628800. Epub 2016 Feb 12.

Abstract

Malignant pleural mesothelioma (MPM) represents a significant diagnostic and therapeutic challenge and is almost always a fatal disease. Imaging abnormalities are common, but have a limited role in distinguishing mesothelioma from metastatic pleural disease. Similarly, minimally invasive biomarkers have shown promise but also have limitations in the diagnosis of mesothelioma. In experienced centers, cytology and immunohistochemistry are now sufficient to diagnose the epithelioid subtype of mesothelioma, which can reduce the need for more invasive diagnostic investigations. Prognosis of MPM is modestly impacted by oncological treatments. Chemotherapy with cisplatin and pemetrexed is considered the standard of care, though the addition of bevacizumab to the platinum doublet may be the new standard of care. New targeted therapies have demonstrated some promise and are being addressed in clinical trials. This review focuses on the current data on the diagnostic and therapeutic issues of MPM.

Keywords: angiogenesis; chemotherapy; clinical trials; diagnosis; immunotherapy; mesothelioma; symptom management.

Publication types

  • Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Bevacizumab / administration & dosage
  • Biomarkers, Tumor / metabolism
  • Cisplatin / administration & dosage
  • Humans
  • Lung Neoplasms / diagnosis
  • Lung Neoplasms / drug therapy*
  • Lung Neoplasms / pathology
  • Mesothelioma / diagnosis
  • Mesothelioma / drug therapy*
  • Mesothelioma / pathology
  • Molecular Targeted Therapy*
  • Pemetrexed / administration & dosage
  • Pleural Neoplasms / diagnosis
  • Pleural Neoplasms / drug therapy*
  • Pleural Neoplasms / pathology
  • Prognosis

Substances

  • Biomarkers, Tumor
  • Pemetrexed
  • Bevacizumab
  • Cisplatin

Supplementary concepts

  • Mesothelioma, Malignant