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Review
. 2017 Jun;6(3):295-314.
doi: 10.21037/tlcr.2017.06.01.

Novel systemic therapy against malignant pleural mesothelioma

Michael R Mancuso  1 , Joel W Neal  1
Affiliations
Review

Novel systemic therapy against malignant pleural mesothelioma

Michael R Mancuso et al. Transl Lung Cancer Res. 2017 Jun.

Abstract

Malignant pleural mesothelioma is an aggressive tumor of the pleura with an overall poor prognosis. Even with surgical resection, for which only a subset of patients are eligible, long term disease free survival is rare. Standard first-line systemic treatment consists of a platinum analog, an anti-metabolite, and sometimes anti-angiogenic therapy, but there is currently no well-established standard therapy for refractory or relapsed disease. This review focuses on efforts to develop improved systemic therapy for the treatment of malignant pleural mesothelioma (MPM) including cytotoxic systemic therapy, a variety of tyrosine kinase inhibitors and their downstream effector pathways, pharmacologic targeting of the epigenome, novel approaches to target proteins expressed on mesothelioma cells (such as mesothelin), arginine depletion therapy, and the emerging role of immunotherapy. Overall, these studies demonstrate the challenges of improving systemic therapy for MPM and highlight the need to develop therapeutic strategies to control this disease.

Keywords: Mesothelioma; chemotherapy; clinical trials; immunotherapy; mesothelin.

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Conflict of interest statement

Conflicts of Interest: MR Mancuso has no conflicts of interest to declare. JW Neal has consulting or advisory roles with Clovis Oncology, Boehringer Ingelheim, ARMO Biosciences, Nektar Therapeutics, ARIAD pharmaceuticals/Takeda, Eli Lilly and Company, and Physician Resource Management. JW Neal receives research funding from Genentech/Roche, Merck, ArQule, Novartis, Boehringer Ingelheim, Nektar, and ARIAD. JW Neal does not have conflicts of interest to declare relating to employment, leadership, stocks and ownership interests, honoraria, patents, royalties, or other intellectual property, expert testimony, or receiving of travel expenses.

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