Update on biology and management of mesothelioma

Abstract

Malignant pleural mesothelioma is an aggressive, incurable cancer that is usually caused by asbestos exposure several decades before symptoms arise. Despite widespread prohibition of asbestos production and supply, its incidence continues to increase. It is heterogeneous in its presentation and behaviour, and diagnosis can be notoriously difficult. Identification of actionable gene mutations has proven challenging and current treatment options are largely ineffective, with a median survival of 10–12 months.However, the past few years have witnessed major advances in our understanding of the biology and pathogenesis of mesothelioma. This has also revealed the limitations of existing diagnostic algorithms and identified new treatment targets.Recent clinical trials have re-examined the role of surgery, provided new options for the management of associated pleural effusions and heralded the addition of targeted therapies. The increasing complexity of mesothelioma management, along with a desperate need for further research, means that a multidisciplinary team framework is essential for the delivery of contemporary mesothelioma care.This review provides a synthesised overview of the current state of knowledge and an update on the latest research in the field.

Cancer incidence in sites potentially related to occupational exposures: 58 years of follow-up of firefighters in the Norwegian Fire Departments Cohort

“…The elevated incidence of mesothelioma found in our study is similar to that found previously for Norwegian firefighters (SIR 2.78, 95% CI 1.02-6.06) (21), and is in line with findings from recent meta-analyses (19,20). Inhalation of asbestos dust is the main cause of mesothelioma (30). Consistent with the frequently seen 30-to 40-year latency period for mesothelioma development following first asbestos exposure (30), we observed elevated incidence of mesothelioma among firefighters observed ≥40 years since first employment (6 cases).…”

The Updating of Biological Functions of Methyltransferase SETDB1 and Its Relevance in Lung Cancer and Mesothelioma

“…With a highly unfavorable prognosis, malignant mesothelioma is a rare, incurable, aggressive and highly lethal malignancy originating from the lining layers of the viscera such as the pleura, peritoneum or pericardium [ 17 , 136 , 137 , 138 , 139 , 140 ]. Mesothelioma is divided into three histological subtypes: epithelioid, sarcomatoid, and biphasic [ 15 ].…”

“…Mesothelioma is divided into three histological subtypes: epithelioid, sarcomatoid, and biphasic [ 15 ]. The pathogenesis of mesothelioma is multifactorial but not fully understood, and the most common inducement is asbestos fibre exposure and inhalation [ 136 , 139 ]. Germline mutations of tumour-suppressing genes have also been confirmed as the main inducements of mesothelioma tumourigenesis [ 141 ].…”

Ferroptosis-dependent extracellular vesicles from macrophage contribute to asbestos-induced mesothelial carcinogenesis through loading ferritin

“…Pleural and peritoneal malignant mesotheliomas have been associated with occupational and/or environmental exposures to asbestos, such as crocidolite, amosite, and chrysotile [ 1 ]. Crocidolite may be responsible for more deaths than any other type of asbestos due to its rigid linearity and thinness, with the ratio of potency for mesothelioma (pleural and peritoneal combined) being 500:100:1 for crocidolite, amosite and chrysotile, respectively [ 2 ].…”