title: Malignant pleural mesothelioma: an update on diagnosis and treatment options.
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.
authors.affiliation: Department of Medical Oncology, Fiona Stanley Hospital, Murdoch, Western Australia, Australia.
authors.forename: Sanjana
authors.initials: S
authors.lastname: Kondola
authors.affiliation: Department of Respiratory Medicine, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia.
authors.forename: David
authors.initials: D
authors.lastname: Manners
authors.affiliation: School of Medicine and Pharmacology, University of Western Australia, M503 35 Stirling Hwy Crawley, WA 6009 Australia anna.nowak@uwa.edu.au.
authors.forename: Anna K
authors.initials: AK
authors.lastname: Nowak
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use; D000068258:Bevacizumab / Q000008:administration & dosage; D014408:Biomarkers, Tumor / Q000378:metabolism; D002945:Cisplatin / Q000008:administration & dosage; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis / Q000188:drug therapy* / Q000473:pathology; D008654:Mesothelioma / Q000175:diagnosis / Q000188:drug therapy* / Q000473:pathology; D000086002:Mesothelioma, Malignant; D058990:Molecular Targeted Therapy; D000068437:Pemetrexed / Q000008:administration & dosage; D010997:Pleural Neoplasms / Q000175:diagnosis / Q000188:drug therapy* / Q000473:pathology; D011379:Prognosis
chemical_list: D014408:Biomarkers, Tumor; D000068437:Pemetrexed; D000068258:Bevacizumab; D002945:Cisplatin
keywords: angiogenesis; chemotherapy; clinical trials; diagnosis; immunotherapy; mesothelioma; symptom management