Unleashing precision: A review of targeted approaches in pleural mesothelioma

Critical Reviews in Oncology and Hematology 2024 August 17 [Link]

Mario Occhipinti, Marta Brambilla, Raimondo Di Liello, Paolo Ambrosini, Lorenzo Lobianco, Rita Leporati, Maria Salvarezza, Fabiana Vitiello, Silvia Marchesi, Sara Manglaviti, Teresa Beninato, Laura Mazzeo, Claudia Proto, Arsela Prelaj, Roberto Ferrara, Carminia Maria Della Corte, Giuseppe Lo Russo, Filippo de Braud, Monica Ganzinelli, Giuseppe Viscardi

Abstract

This review delves into the intricate landscape of pleural mesothelioma (PM), emphasizing the need for nuanced therapeutic strategies. While platinum-based chemotherapy remains a cornerstone, the advent of immune checkpoint inhibitors (ICIs), notably through the Checkmate 743 trial, has reshaped treatment paradigms. Challenges persist due to patient heterogeneity and a lack of specific biomarkers. Targeting genotypic and phenotypic alterations emerges as a promising avenue, demanding precision oncology in this rare disease. CDKN2A loss, prevalent in PM, may respond to CDK4/6 inhibitors. Defects in MMR and HR suggest tailored approaches with ICI or PARP inhibitors, respectively. Ongoing trials explore novel inhibitors and promising targets like mesothelin. Implementing these strategies requires overcoming challenges in patient selection, combination therapies, biomarker identification, and cost considerations. Collaboration is crucial for transforming these insights into impactful clinical interventions, heralding the era of personalized and precision medicine for PM.