title: Advances in the systemic therapy of malignant pleural mesothelioma.
abstract: Malignant pleural mesothelioma is an aggressive thoracic malignancy associated with exposure to asbestos, and its incidence is anticipated to increase during the first half of this century. Chemotherapy is the mainstay of treatment, yet sufficiently robust evidence to substantiate the current standard of care has emerged only in the past 5 years. This Review summarizes the evidence supporting the clinical activity of chemotherapy, discusses the use of end points for its assessment and examines the influence of clinical and biochemical prognostic factors on the natural history of malignant pleural mesothelioma. Early-phase clinical trials of second-line and novel agents are emerging from an increased understanding of mesothelioma cell biology. Coupled with high-quality translational research, such developments have real potential to improve the outlook of patients at a time of increasing incidence.
authors.affiliation: Centre for Cancer Research and Cell Biology, Queen's University Belfast, 97 Liburn Road, Belfast BT9 7BL, Northern Ireland, UK. d.fennell@qub.qc.uk
authors.forename: Dean A
authors.initials: DA
authors.lastname: Fennell
authors.forename: Giovanni
authors.initials: G
authors.lastname: Gaudino
authors.forename: Kenneth J
authors.initials: KJ
authors.lastname: O'Byrne
authors.forename: Luciano
authors.initials: L
authors.lastname: Mutti
authors.forename: Jan
authors.initials: J
authors.lastname: van Meerbeeck
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use*; D014408:Biomarkers, Tumor; D003131:Combined Modality Therapy; D005493:Folic Acid Antagonists / Q000627:therapeutic use; D020869:Gene Expression Profiling; D006801:Humans; D008654:Mesothelioma / Q000188:drug therapy* / Q000235:genetics / Q000473:pathology; D017671:Platinum Compounds / Q000627:therapeutic use; D010997:Pleural Neoplasms / Q000188:drug therapy* / Q000235:genetics / Q000473:pathology; D049268:Positron-Emission Tomography; D011379:Prognosis; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D014408:Biomarkers, Tumor; D005493:Folic Acid Antagonists; D017671:Platinum Compounds