Malignant Pleural Mesothelioma

Abstract

OverviewMalignant pleural mesothelioma is an aggressive malignancy with an incidence that may be peaking worldwide. While the majority of patients do ultimately die of this disease, there have been substantial treatment and diagnostic shifts over the past decade that may improve long‐term outcomes. These changes include worldwide interest in defining early detection biomarkers for the disease, a debate as to the optimal surgical approach (extrapleural pneumonectomy vs lung‐sparing methods such as pleurectomy/decortication), further refinement of radiation techniques that allow for conformal treatment fields and the delivery of radiation with the involved lung intact, and the emergence of systemic therapies that are targeted in nature and allow for the increased individualization of care. Indeed, prospective clinical trials assessing the safety and efficacy of novel treatment approaches will be essential to the standardization of paradigms that improve outcomes. It is hoped that the maturation of these efforts will lead to an optimal approach in which earlier stage patients will benefit from multiple modalities that will provide synergistic control while limiting toxicity, thereby increasing the number of long‐term survivors over the next one to two decades.