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Malignant Pleural Mesothelioma: Is Tailoring the Second-Line Therapy Really “Raising the Bar?”

  • Lung Cancer (HA Wakelee, Section Editor)
  • Published:
Current Treatment Options in Oncology Aims and scope Submit manuscript

Opinion statement

Unresectable or relapsed malignant pleural mesothelioma (MPM) has dismal prognosis. First-line combination therapy with pemetrexed and a platinum analog allows a modest survival benefit, while no clear therapeutic options exist for the second-line therapy. In this setting, pemetrexed seems to be the most active drug; however, the inclusion in front-line treatment limits its use in further lines. Nevertheless, rechallenge with one or both drugs used in first-line remains a feasible strategy for responder patients. Alternatively, only few cytotoxic drugs have demonstrated a mild activity in refractory MPM. Among other options, targeted therapy has unfortunately produced disappointing results as salvage treatment probably due to the lack of a clear understanding of the tumor biology. In contrast, recent data suggest moderate efficacy and mild toxicity of immunotherapy also for the treatment of MPM. The combination of checkpoint inhibitors with chemotherapy or other immunological agents seems promising and could really “raise the bar” in this setting.

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Papers of particular interest, published recently, have been highlighted as: •• Of major importance

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  1. UOC di Oncologia Medica – Università Cattolica del Sacro Cuore - Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Francesco Vito 1, 00168, Rome, Italy

    Vincenzo Di Noia MD, Emanuele Vita MD, Miriam Ferrara MD, Antonia Strippoli MD PhD, Michele Basso MD PhD, Giovanni Schinzari MD PhD, Alessandra Cassano MD PhD, Emilio Bria MD, Carlo Barone MD PhD & Ettore D’Argento MD PhD

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Di Noia, V., Vita, E., Ferrara, M. et al. Malignant Pleural Mesothelioma: Is Tailoring the Second-Line Therapy Really “Raising the Bar?”. Curr. Treat. Options in Oncol. 20, 23 (2019). https://doi.org/10.1007/s11864-019-0616-7

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