title: Malignant pleural mesothelioma: an update on investigation, diagnosis and treatment.
abstract: Malignant pleural mesothelioma is an aggressive malignancy of the pleural surface, predominantly caused by prior asbestos exposure. There is a global epidemic of malignant pleural mesothelioma underway, and incidence rates are predicted to peak in the next few years.This article summarises the epidemiology and pathogenesis of malignant pleural mesothelioma, before describing some key factors in the patient experience and outlining common symptoms. Diagnostic approaches are reviewed, including imaging techniques and the role of various biomarkers. Treatment options are summarised, including the importance of palliative care and methods of controlling pleural effusions. The evidence for chemotherapy, radiotherapy and surgery is reviewed, both in the palliative setting and in the context of trimodality treatment. An algorithm for managing malignant pleural effusion in malignant pleural mesothelioma patients is presented. Finally new treatment developments and novel therapeutic approaches are summarised.
authors.affiliation: Academic Respiratory Unit, University of Bristol, Bristol ,UK Anna.Bibby@bristol.ac.uk.|North Bristol NHS Trust, Bristol, UK.
authors.forename: Anna C
authors.initials: AC
authors.lastname: Bibby
authors.affiliation: Queen Elizabeth University Hospital, Glasgow, UK.|Institute of Cancer Sciences, University of Glasgow, Glasgow, UK.
authors.forename: Selina
authors.initials: S
authors.lastname: Tsim
authors.affiliation: Respiratory Trials Unit, University of Oxford, Churchill Hospital, Oxford, UK.|Oxford Centre for Respiratory Medicine, Churchill Hospital, Oxford, UK.
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Kanellakis
authors.affiliation: Oxford Centre for Respiratory Medicine, Churchill Hospital, Oxford, UK.|Dept of Oncology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
authors.forename: Hannah
authors.initials: H
authors.lastname: Ball
authors.affiliation: Dept of Oncology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
authors.forename: Denis C
authors.initials: DC
authors.lastname: Talbot
authors.affiliation: Queen Elizabeth University Hospital, Glasgow, UK.|Institute of Infection, Immunity and Inflammation, University of Glasgow, Glasgow, UK.
authors.forename: Kevin G
authors.initials: KG
authors.lastname: Blyth
authors.affiliation: Academic Respiratory Unit, University of Bristol, Bristol ,UK.|North Bristol NHS Trust, Bristol, UK.
authors.forename: Nick A
authors.initials: NA
authors.lastname: Maskell
authors.affiliation: Respiratory Trials Unit, University of Oxford, Churchill Hospital, Oxford, UK.|Oxford Centre for Respiratory Medicine, Churchill Hospital, Oxford, UK.
authors.forename: Ioannis
authors.initials: I
authors.lastname: Psallidas
mesh_terms: D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy*; D008654:Mesothelioma / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy*; D000086002:Mesothelioma, Malignant; D010997:Pleural Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy*; D011237:Predictive Value of Tests; D016896:Treatment Outcome