Current Management and Future Perspective in Pleural Mesothelioma

SIMPLE SUMMARY: Platin-based chemotherapy with pemetrexed has been the backbone of meaningful treatment in pleural mesothelioma for the last 16 years, alongside vinorelbine and gemcitabine, which show only modest response. Recently, a nivolumab and ipilimumab combination was approved, and it offers improvement in survival rate and quality of life. With the identification and understanding of novel biomarkers, many treatment options are currently being evaluated. ABSTRACT: Pleural mesothelioma is an aggressive malignancy arising from pleural mesothelial cell lining, predominantly associated with prior exposure to asbestos. The ban on asbestos use has led to its lower incidence in many countries, but globally the disease burden is expected to rise. Therefore, well-planned research is needed to develop more effective, tolerable and affordable drugs. The development of novel treatment has been too slow, with only two regimens of systemic therapy with robust phase 3 data approved formally to date. The treatment scenario for resectable disease remains controversial. However, recent developments in the understanding of disease and clinical trials have been encouraging, and may add better treatment options in the coming years. In this review, we discuss the current treatment options for pleural mesothelioma and shed light on some recent studies and ongoing trials.