title: Targeting the vasculature: anti-angiogenic agents for malignant mesothelioma.
abstract: Malignant mesothelioma (MM) is an aggressive malignancy of the pleura and other serosal membranes originating from mesothelial cells that, despite decades of research, continues to have limited therapeutic options and is associated with a poor prognosis. Areas covered: MMs induce a strong inflammatory response that is also associated with neoangiogenesis and activation of proangiogenic factors. Given this, several anti-angiogenic agents have been trialled in a variety of malignancies including mesothelioma. Herein we summarise the role of angiogenesis in MM and the current available data targeting these pathways. Expert commentary: The addition of bevacizumab to cisplatin/pemetrexed chemotherapy is currently a therapeutic option with a proven 2.7 month overall survival benefit in fit patients less than 75. Other antiangiogenics such as nintedinib show early promise, although the Phase III trial results are eagerly awaited before this therapy enters treatment paradigms. Beyond this, it is likely that combinations of antiangiogenics with immunotherapies will be investigated in future studies.
authors.affiliation: a Department of Medical Oncology , Austin Health , Melbourne , Australia.|b Olivia-Newton John Cancer Research Institute, Austin Health , Melbourne , Australia.
authors.forename: Puey Ling
authors.initials: PL
authors.lastname: Chia
authors.affiliation: c Department of Anatomical Pathology , St. Vincent's Hospital, University of Melbourne , Melbourne , Australia.
authors.forename: Prudence A
authors.initials: PA
authors.lastname: Russell
authors.affiliation: b Olivia-Newton John Cancer Research Institute, Austin Health , Melbourne , Australia.|d School of Cancer Medicine , La Trobe University , Melbourne , Australia.|e Department of Molecular Imaging and Therapy , Austin Health , Melbourne , Australia.|f Faculty of Medicine , University of Melbourne , Melbourne , Australia.
authors.forename: Andrew M
authors.initials: AM
authors.lastname: Scott
authors.affiliation: a Department of Medical Oncology , Austin Health , Melbourne , Australia.|b Olivia-Newton John Cancer Research Institute, Austin Health , Melbourne , Australia.|d School of Cancer Medicine , La Trobe University , Melbourne , Australia.
authors.forename: Thomas
authors.initials: T
authors.lastname: John
mesh_terms: D020533:Angiogenesis Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D000818:Animals; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D008175:Lung Neoplasms / Q000098:blood supply / Q000188:drug therapy* / Q000473:pathology; D008654:Mesothelioma / Q000098:blood supply / Q000188:drug therapy* / Q000473:pathology; D000086002:Mesothelioma, Malignant; D011379:Prognosis; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D020533:Angiogenesis Inhibitors
keywords: Mesothelioma; angiogenesis; anti-angiogenic agents; tumour microenvironment; vascular endothelial growth factor