Emerging New Targets in Systemic Therapy for Malignant Pleural Mesothelioma

Simple Summary Malignant pleural mesothelioma is an aggressive cancer that is not surgically resectable for the majority of patients diagnosed with it. Chemotherapy or immunotherapy is the current standard of care for patients with advanced malignant pleural mesothelioma. Cancer drugs that specifically target genetic alterations in mesothelioma have not yet been approved. In this clinical review, we discuss the promising molecular targets and progress made in precision medicine in malignant pleural mesothelioma.Abstract Malignant pleural mesothelioma (MPM) is a heterogeneous cancer composed of distinct molecular and pathologic subtypes. Unfortunately, MPM is aggressive, and current therapies for advanced, unresectable disease remain limited to cytotoxic chemotherapy and immunotherapy. Our understanding of the genomic landscape of MPM is steadily growing, while the discovery of effective targeted therapies in MPM has advanced more slowly than in other solid tumors. Given the prevalence of alterations in tumor suppressor genes in MPM, it has been challenging to identify actionable targets. However, efforts to characterize the genetic signatures in MPM over the last decade have led to a range of novel targeted therapeutics entering early-phase clinical trials. In this review, we discuss the advancements made thus far in targeted systemic therapies in MPM and the future direction of targeted strategies in patients with advanced MPM.