Advances in the systemic therapy of malignant pleural mesothelioma

Nature Clinical Practice Oncology. 2008 Jan 29 [Epub ahead of print] [Link]

Fennell DA, Gaudino G, O’Byrne KJ, Mutti L, van Meerbeeck J; Medscape.

DA Fennell is a Cancer Research UK Clinician Scientist, Consultant and Senior Lecturer in Medical Oncology at Queen’s University Belfast and at the Northern Ireland Cancer Centre, Belfast, Northern Ireland, UK.


Malignant pleural mesothelioma is an aggressive thoracic malignancy associated with exposure to asbestos, and its incidence is anticipated to increase during the first half of this century. Chemotherapy is the mainstay of treatment, yet sufficiently robust evidence to substantiate the current standard of care has emerged only in the past 5 years. This Review summarizes the evidence supporting the clinical activity of chemotherapy, discusses the use of end points for its assessment and examines the influence of clinical and biochemical prognostic factors on the natural history of malignant pleural mesothelioma. Early-phase clinical trials of second-line and novel agents are emerging from an increased understanding of mesothelioma cell biology. Coupled with high-quality translational research, such developments have real potential to improve the outlook of patients at a time of increasing incidence.