Diagnosis and management of mesothelioma

Malignant pleural mesothelioma is a rare, but aggressive malignancy associated with prior asbestos exposure. Most patients present with advanced disease and the median survival is on the order of one year. Although treatment of this deadly disease is challenging, recent studies have helped to improve patient selection for aggressive therapies and shape treatment algorithms according to specific disease characteristics. A multimodal approach in appropriate patients has been shown to yield the best outcomes, and the surgical paradigm has shifted to favor a less morbid lung-sparing operation. Although platinum-based chemotherapy remains the standard for systemic therapy, targeted agents continue to be investigated as second-line or adjunct treatment options.