Advances in the Medical Treatment of Malignant Mesothelioma

Malignant Pleural Mesothelioma (MPM) is a highly lethal and refractory malignancy that is caused by asbestos exposure. Surgical resection, radiotherapy, and other local treatments are of limited efficacy. Therefore, systemic chemotherapy plays an important role in improving of treatment outcomes for MPM. The findings of a largescale phase III study led to the approval of a novel antifolate, pemetrexed, by the U.S. Food and Drug Administration (FDA), making pemetrexed the world’s first therapeutic agent for MPM. Further, the combination treatment of pemetrexed plus cisplatin has been recognized as standard chemotherapy for this disease in the first-line setting. Recent studies have provided evidence that second-line chemotherapy is associated with prolonged survival among patients with various malignancies, including MPM. To date, however, no chemotherapeutic regimens have been recommended for MPM in the second-line setting. Furthermore, although, systemic chemotherapy is carried out in the majority of medical cases of MPM, it has not been established whether this systemic chemotherapy contributes to prolonged survival. This article reviews the latest findings regarding chemotherapy in cases of MPM and focuses on new medical treatments including molecular targeted therapies.