The Current Treatment Landscape of Malignant Pleural Mesothelioma and Future Directions

Simple Summary Malignant pleural mesothelioma is an invasive and drug-resistant tumor related to asbestos exposure, with limited therapy options. It is associated with an unfavorable prognosis and a 5-year survival rate of only 12%. Current standard-of-care treatment based on platinum-pemetrexed chemotherapy has been in place for the past two decades, though survival is increased by just a few months. In this article, we aim to review the current chemotherapy and immunotherapy options for this malignancy and highlight recent developments with regard to chemoimmunotherapy, targeted agents and cellular therapy.Abstract The incidence of malignant pleural mesothelioma is expected to increase globally. New treatment options for this malignancy are eagerly awaited to improve the survival and quality of life of patients. The present article highlights the results of recent advances in this field, analyzing data from several relevant trials. The heterogeneous tumor microenvironment and biology, together with the low mutational burden, pose a challenge for treating such tumors. So far, no single biomarker has been soundly correlated with targeted therapy development; thus, combination strategies are often required to improve outcomes. Locally applied vaccines, the expansion of genetically engineered immune cell populations such as T cells, the blockage of immune checkpoints that inhibit anti-tumorigenic responses and chemoimmunotherapy are among the most promising options expected to change the mesothelioma treatment landscape.