Malignant pleural mesothelioma: current treatments and emerging drugs.
BACKGROUND
Malignant pleural mesothelioma (MPM) is an uncommon disease whose incidence is increasing worldwide over the past 30 years. Surgical resection and radiotherapy represent the standard treatment in patient with resectable MPM. Chemotherapy is also necessary to reduce incidence of distant metastases, but the optimal setting of treatment (neoadjuvant, adjuvant and intrapleural) is not clarified. For the patients with unresectable MPM, the combination cisplatin and pemetrexed or ralitrexed is the standard treatment as supported by a Phase III study. Better understanding of molecular pathways involved in MPM has enabled inclusion of new drugs targeted against pathways responsible for proliferation, cell survival and angiogenesis.


OBJECTIVE
This review discusses the current treatment option, the specific signal pathways activated in MPM and the novel agents under evaluation in clinical trials.


METHODS
We use for this article abstracts, papers, oral presentations from ASCO and the website http://www.clinical-trials.gov. RESULTS/ CONCLUSION: This review summarizes the activity of chemotherapy and of new agents under evaluation in clinical trials. The better understanding of molecular pathways activated in MPM will hopefully provide new therapeutic options for these patients in the future.
Belli
Carmen
C
San Raffaele Scientific Institute, Oncology Department, 60 Olgettina Street, Milan 20132, Italy. belli.carmen@hsr.it
Fennell
Dean
D
Giovannini
Monica
M
Gaudino
Giovanni
G
Mutti
Luciano
L
D000970:Antineoplastic Agents / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D017326:Clinical Trials, Phase III as Topic; D003131:Combined Modality Therapy; D015195:Drug Design; D005493:Folic Acid Antagonists / Q000627:therapeutic use; D006801:Humans; D008654:Mesothelioma / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D010997:Pleural Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery
D000970:Antineoplastic Agents; D005493:Folic Acid Antagonists