Chemotherapy for Malignant Pleural Mesothelioma: Past, Present and Future

Abstract

Purpose of Review

This paper aims to propose an update on therapeutic medical options for malignant pleural mesothelioma (MPM).

Recent Findings

For 13 years, the standard of care in MPM patients has been cisplatin/pemetrexed chemotherapy. Recently, the Cis/Pem/bevacizumab triplet emerged as a new option for MPM patients eligible for bevacizumab, and not as a candidate for multimodality therapy trials, as validated by the last NCCN and French guidelines. Immunotherapy is also emerging as a promising option on its own or in combination with first-line Cis/Pem, or even as a valuable alternative to chemotherapy, radical surgery, and multimodality strategies.

Summary

Targeted therapies and immunotherapy are new promising treatments in MPM as single agents or in combination with chemotherapy. However, the key challenge remains to find reliable predictive biomarkers for these innovative, exciting, and expensive treatments to select the best patients for each strategy. After years of nihilism and negative trials, numerous therapeutic strategies can now be offered to mesothelioma patients and the future looks brighter.

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