Targeting angiogenesis for patients with unresectable malignant pleural mesothelioma

Semin Oncol. 2019 Apr;46(2):145-154. doi: 10.1053/j.seminoncol.2019.06.001. Epub 2019 Jun 18.


Malignant pleural mesothelioma (MPM) is a global health issue, the principal cause of which is exposure to asbestos. The prevalence is anticipated to rise over the next 2 decades, particularly in developing countries, due to the 30-50-year latency period between exposure to asbestos and carcinogenic development. Unresectable MPM has a poor prognosis and limited treatment options and, as such, there is a broad range of therapeutic targets of interest, including angiogenesis, immune checkpoints, mesothelin, as well as chemotherapeutic agents. Recently, the results of several randomized trials in the first-line setting combining antiangiogenic agents with chemotherapy have been reported. This review examines the scientific rationale for targeting angiogenesis in the treatment of unresectable MPM and analyzes recent clinical results with antiangiogenic agents in development (bevacizumab, nintedanib, and cediranib) for the management of MPM.

Keywords: Angiogenesis; Asbestos; Malignant pleural mesothelioma.

Publication types

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

MeSH terms

  • Asbestos / toxicity
  • Bevacizumab / therapeutic use
  • Carcinogenesis / drug effects*
  • Carcinogenesis / genetics
  • Humans
  • Indoles / therapeutic use
  • Lung Neoplasms / drug therapy*
  • Lung Neoplasms / genetics
  • Lung Neoplasms / pathology
  • Mesothelioma / drug therapy*
  • Mesothelioma / genetics
  • Mesothelioma / pathology
  • Mesothelioma, Malignant
  • Neovascularization, Pathologic / drug therapy*
  • Neovascularization, Pathologic / genetics
  • Neovascularization, Pathologic / pathology
  • Pleural Neoplasms / drug therapy*
  • Pleural Neoplasms / genetics
  • Pleural Neoplasms / pathology
  • Quinazolines / therapeutic use


  • Indoles
  • Quinazolines
  • Asbestos
  • Bevacizumab
  • nintedanib
  • cediranib