Targeted therapies in malignant pleural mesothelioma: a review of clinical studies
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Updated: Jun 5, 2026
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Published on: December 21, 2019
Laurent Greillier1, Sabine Marco, Fabrice Barlesi
1Service d'Oncologie Multidisciplinaire et Innovations Thérapeutiques, Université de la Méditerranée-Assistance Publique Hôpitaux de Marseille, Marseille, France.
Abstract:
Malignant pleural mesothelioma (MPM) is an aggressive tumor with poor prognosis, whose exposure to asbestos fibers is the main etiology. The incidence of MPM is anticipated to increase worldwide during the first half of this century. MPM is notoriously refractory to most treatments, and the only standard of care is cisplatin and antifolate first-line chemotherapy. The urgent need for additional therapeutic agents, in parallel with advances in the knowledge of the molecular events of oncogenesis, has resulted in the development of the so-called 'targeted agents' that specifically inhibit critical pathways in malignant cells and in their microenvironment. We carried out a comprehensive review of the literature from January 2000 to May 2010 on studies that assessed targeted agents for the systemic treatment of MPM. Although tyrosine kinase inhibitors directed against the epidermal growth factor and the platelet-derived growth factor receptors did not show significant clinical activity in phase II studies, some other targeted therapies seemed promising, notably histone deacetylase inhibitors and antiangiogenic agents. However, none of these has yet reached daily practice. That is the reason why efforts must continue in the area of clinical and translational research for MPM.
Insights
Malignant pleural mesothelioma (MPM) treatment remains challenging. While targeted agents show promise, particularly histone deacetylase inhibitors and antiangiogenic therapies, none are standard care, necessitating continued research.
Area of Science:
- Oncology
- Thoracic Surgery
- Medical Oncology
Background:
- Malignant pleural mesothelioma (MPM) is an aggressive asbestos-related cancer with a poor prognosis.
- Current standard treatment relies on cisplatin and antifolate chemotherapy, with limited efficacy.
- The incidence of MPM is projected to rise globally in the coming decades.
Purpose of the Study:
- To review the literature on targeted agents for systemic treatment of MPM.
- To evaluate the clinical activity and potential of novel targeted therapies.
- To identify promising therapeutic avenues beyond conventional chemotherapy.
Main Methods:
- Comprehensive literature review of studies published between January 2000 and May 2010.
- Focus on systemic targeted agents for malignant pleural mesothelioma treatment.
- Analysis of phase II clinical trial data for efficacy and activity.
Main Results:
- Tyrosine kinase inhibitors targeting EGFR and PDGF receptors showed limited clinical activity in phase II studies.
- Histone deacetylase inhibitors and antiangiogenic agents demonstrated promising results.
- No targeted agents reviewed have yet been integrated into standard clinical practice for MPM.
Conclusions:
- Targeted therapies offer potential for improved malignant pleural mesothelioma treatment.
- Further clinical and translational research is crucial to develop effective targeted agents.
- Continued investigation is needed to overcome treatment refractoriness in MPM.
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