[Malignant pleural mesothelioma: 2013 state of the art].
Malignant pleural mesothelioma (MPM) is a bad-prognosis cancer raising difficult issues according to diagnosis. Reliable histological diagnosis indeed requires large-sized pathological samples obtained by thoracoscopy, and need diagnosis certification by the MESOPATH national expert pathological committee. MPM epidemiology shows a rising incidence among females, whereas an incidence plateau has been reached for males in France. The incidence peak is still predicted for 2030 decade in UK, Australia and North America, because of the asbestosis massive use in their industry until the end of 1980 decade. Pleural carcinogenesis is better understood with the recent discovery of BAP1 susceptibility gene although no oncogenic driver has been ever uncovered for targeted therapies, although several more or less targeted biological therapies are currently tested in early phase or more advanced-phase trials. Surgery is more and more questioned, since radical surgery is currently abandoned, whereas debulking or cyto-reduction surgery has been proposed within a multimodality approach also including adjuvant chemotherapy and radiotherapy but still need prospective trials. Pemetrexed and cisplatin-based chemotherapy remains the reference treatment, which has proved in mesothelioma some efficacy on overall survival in randomized trials, with a 13-15 months median-overall survival. Final results of the large phase 3 clinical trial "MAPS" sponsored by French collaborative Intergroup (IFCT) evaluating the effect of bevacizumab addition to pemetrexed-cisplatin doublet will be released in early 2015, since 445 patients have been included by November 2013.
Université de Caen-Basse Normandie, CHU de Caen, service de pneumologie et oncologie thoracique, avenue de la Côte-de-Nacre, 14033 Caen cedex 05, France.
Karine
K
Campbell
Université de Caen-Basse Normandie, CHU de Caen, service de pneumologie et oncologie thoracique, avenue de la Côte-de-Nacre, 14033 Caen cedex 05, France.
Solenn
S
Brosseau
Université de Caen-Basse Normandie, CHU de Caen, service de pneumologie et oncologie thoracique, avenue de la Côte-de-Nacre, 14033 Caen cedex 05, France.
Lucie
L
Reviron-Rabec
Université de Caen-Basse Normandie, CHU de Caen, service de pneumologie et oncologie thoracique, avenue de la Côte-de-Nacre, 14033 Caen cedex 05, France, CHU de Caen, UMR Inserm 1086 « Cancers et Préventions », avenue Côte-de-Nacre, 14033 Caen Cedex 05 France, Intergroupe francophone de cancérologie thoracique (IFCT), 10, rue de la Grange-Batelière, 75009 Paris, France.
Emmanuel
E
Bergot
Université de Caen-Basse Normandie, CHU de Caen, département d'anatomie pathologique, avenue de la Côte-de-Nacre, 14033 Caen cedex 05, France.
Emmanuèle
E
Lechapt
Université de Caen-Basse Normandie, CHU de Caen, département d'anatomie pathologique, avenue de la Côte-de-Nacre, 14033 Caen cedex 05, France, Intergroupe francophone de cancérologie thoracique (IFCT), 10, rue de la Grange-Batelière, 75009 Paris, France.
Guénaëlle
G
Levallet
Université de Caen-Basse Normandie, CHU de Caen, service de pneumologie et oncologie thoracique, avenue de la Côte-de-Nacre, 14033 Caen cedex 05, France, CHU de Caen, UMR Inserm 1086 « Cancers et Préventions », avenue Côte-de-Nacre, 14033 Caen Cedex 05 France, Intergroupe francophone de cancérologie thoracique (IFCT), 10, rue de la Grange-Batelière, 75009 Paris, France.
Gérard
G
Zalcman
D020533:Angiogenesis Inhibitors / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage; D000970:Antineoplastic Agents / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001195:Asbestosis / Q000150:complications; D000068258:Bevacizumab; D002945:Cisplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy / Q000379:methods; D005260:Female; D005602:France / Q000453:epidemiology; D020022:Genetic Predisposition to Disease / Q000235:genetics; D005971:Glutamates / Q000008:administration & dosage; D006147:Guanine / Q000008:administration & dosage / Q000031:analogs & derivatives; D006801:Humans; D015994:Incidence; D008175:Lung Neoplasms / Q000453:epidemiology / Q000235:genetics / Q000473:pathology / Q000628:therapy; D008297:Male; D008654:Mesothelioma / Q000453:epidemiology / Q000235:genetics / Q000473:pathology / Q000628:therapy; D000086002:Mesothelioma, Malignant; D058990:Molecular Targeted Therapy / Q000379:methods; D000068437:Pemetrexed; D010997:Pleural Neoplasms; D011379:Prognosis; D025521:Tumor Suppressor Proteins / Q000235:genetics; D043222:Ubiquitin Thiolesterase / Q000235:genetics
D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents; C400134:BAP1 protein, human; D005971:Glutamates; D025521:Tumor Suppressor Proteins; D000068437:Pemetrexed; D000068258:Bevacizumab; D006147:Guanine; D043222:Ubiquitin Thiolesterase; D002945:Cisplatin
BAP1; NF2; asbestosis; malignant pleural mesothélioma; pemetrexed; thoracoscopy