Mesotelioma pleural maligno

Abstract

Malignant pleural mesothelioma is an aggressive and rare neoplasm associated with asbestos exposure. Its incidence is increasing in developing countries. It has a poor prognosis, with a median survival time of about one year. The treatments currently available offer limited benefits. Based on the available evidence, the role of radical surgery is controversial because of the high perioperative morbidity and mortality and the tendency for disease recurrence. Platinum- and pemetrexed-based chemotherapy was the cornerstone of the treatment of unresectable disease in patients with good functional reserve. Immunotherapy with nivolumab and ipilimumab has recently emerged as a new standard option, improving survival figures and with manageable toxicity, especially in the non-epithelioid histologic subtype. Pleural effusion and trapped lung are common complications in this disease, so techniques aimed at controlling symptoms are fundamental. It is necessary to conduct new clinical trials and translational research in order to improve survival and quality of life expectations for patients with pleural mesothelioma.