The management of MPM remains a significant challenge, and the prognosis for the vast majority of patients afflicted with this disease remains poor. While the decreased use of asbestos in industry will gradually reduce the worldwide burden of MPM, it is predicted that the incidence of the disease across the world will continue to rise for several decades before the effects of decreased asbestos use are realized. In addition, up to 20% of patients with MPM do not have clear prior asbestos exposure, arguing that the disease will not be eliminated completely in the “post-asbestos” era. Therefore, it is imperative that novel and improved therapies for MPM continue to be developed. At present, most fit patients with MPM are offered platinum-based chemotherapy combinations that modestly improve survival. Surgery and multimodality therapy are offered to selected patients at experienced centers but without clear evidence to truly define the magnitude of benefit of that approach. Recent successes with the addition of bevacizumab to standard chemotherapy and with the possibility of antitumor effects with the immune checkpoint inhibitors in MPM give hope that a better understanding of the biology of this disease will gradually lead to improved outcomes for these patients.
Jonathan Dowell has disclosed that he has received research support from MedImmune, LLC and Verastem, Inc. Shivani Patel has no relevant financial interests to disclose. The authors report no conflicts of interest in this work.
Shivani C. Patel,1 Jonathan E. Dowell1,2
1Division of Hematology and Oncology, University of Texas Southwestern, 2Section of Hematology and Oncology, Veterans Affairs North Texas Healthcare System, Dallas, TX, USA
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