Malignant pleural mesothelioma: interrogations and hopes concerning the expected epidemic

Revue de Pneumologie Clinique. 2007 Dec;63(6):354-64. [Link]

Margery J, Ruffié P.

Service de Pneumologie, Hôpital d’Instruction des Armées Percy, 101, avenue Henri-Barbusse, 92140 Clamart.

Abstract

Malignant pleural mesothelioma (MPM) is a rare incurable tumor. Interest in MPM has increased in recent years due to a steadily increasing incidence subsequent to the intensive use of asbestosis, the main causal agent, but also due to better awareness in the political and scientific communities faced with a serious public health issue. Our knowledge of MPM has improved regularly in terms of pathologic diagnosis and the mechanisms underlying the mesothelial carcinogenesis. MPM is also the subject of many technological innovations as illustrated by the recent identification of new biological markers, access to metabolic imaging, and clinical research on targeted treatments. Proper management implies the participation of the general population since the implementation of administrative procedures for social indemnities. In 2007, a more aggressive therapeutic approach is becoming common practice with the use of radiotherapy and the emergence of the concept of multimodal care centered on wide pleuropneumonectomy. These advances create real hope for improvement, but also many interrogations since no standard treatment protocol has been clearly identified.