Malignant Pleural Mesothelioma: Time Is Running Out

摘要

Malignant pleural mesothelioma (MPM) is a rare but highly malignant disease of the pleura usually related to asbestos exposure. Although it is not officially accepted as an orphan disease, its low incidence imposes significant difficulties to physicians confronted with affected patients. Unlike other neoplasms which have benefited from recent advancements in technologies, new immune-oncological treatments and multiomic approaches (i.e., lung cancer), MPM seems not to have benefited from these new therapeutic frontiers and currently MPM-patients are doomed to a dismal prognosis (expected survival of 9–18 months after diagnosis, according to histological subtype) with substantially no real chance of care. Recently, an increase in interest emerged within the scientific community on this tumor because its incidence has dramatically increased in high income countries in the last years, following the prevision of various prediction models previously developed [1,2]. In 2010 the European Respiratory Society and the European Society of Thoracic Surgeons reported epidemiological projections that estimated an increasing incidence of MPM, with a peak around 2020 [3] and here we stand now with the same principal unsolved questions and substantially the same unsatisfactory therapeutic protocols. First, to early predict MPM in asbestos-exposed subjects is extremely hard. To date, according to the data available on MPM (prevalence, prognosis, and treatment) and the performance (sensitivity, specificity) of potential screening methods, the medical efficacy of large-scale screening is not recommended [3]. Several biological markers have been currently studied and further efforts are needed in this field of research [4].