Immunotherapeutic Approaches in Malignant Pleural Mesothelioma
Related Experiment Video
Updated: Oct 31, 2025
Generation and Expansion of Primary, Malignant Pleural Mesothelioma Tumor Lines
Published on: April 21, 2022
Rita Terenziani1, Silvia Zoppi1, Claudia Fumarola1
1Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy.
Abstract:
Malignant pleural mesothelioma (MPM) is a rare and aggressive malignant disease affecting the mesothelium, commonly associated to asbestos exposure. The current therapeutic actions, based on cisplatin/pemetrexed treatment, are limited due to the late stage at which most patients are diagnosed and to the intrinsic chemo-resistance of the tumor. Another relevant point is the absence of approved therapies in the second line setting following progression of MPM after chemotherapy. Considering the poor prognosis of the disease and the fact that the incidence of this tumor is expected to increase in the next decade, novel therapeutic approaches are urgently needed. In the last few years, several studies have investigated the efficacy and safety of immune-checkpoint inhibitors (ICIs) in the treatment of unresectable advanced MPM, and a number of trials with immunotherapeutic agents are ongoing in both first line and second line settings. In this review, we describe the most promising emerging immunotherapy treatments for MPM (ICIs, engineered T cells to express chimeric antigen receptors (CARs), dendritic cells (DCs) vaccines), focusing on the biological and immunological features of this tumor as well as on the issues surrounding clinical trial design.
Insights
Malignant pleural mesothelioma (MPM) treatment faces challenges due to late diagnosis and chemo-resistance. Emerging immunotherapies like immune-checkpoint inhibitors (ICIs) offer new hope for patients with this aggressive cancer.
Area of Science:
- Oncology
- Immunology
Background:
- Malignant pleural mesothelioma (MPM) is a rare, aggressive cancer linked to asbestos exposure.
- Current treatments (cisplatin/pemetrexed) are limited by late diagnosis and chemo-resistance, with no approved second-line options.
- The incidence of MPM is projected to rise, necessitating novel therapeutic strategies.
Purpose of the Study:
- To review emerging immunotherapy treatments for MPM.
- To focus on the biological and immunological aspects of MPM relevant to immunotherapy.
- To discuss challenges in clinical trial design for MPM immunotherapies.
Main Methods:
- Review of recent studies on immunotherapy efficacy and safety in unresectable advanced MPM.
- Analysis of ongoing clinical trials for first- and second-line immunotherapeutic agents.
- Examination of MPM's biological and immunological characteristics.
Main Results:
- Immune-checkpoint inhibitors (ICIs) show promise in treating advanced MPM.
- Ongoing trials are evaluating various immunotherapeutic agents in both first- and second-line settings.
- Understanding MPM's tumor biology is crucial for effective immunotherapy.
Conclusions:
- Novel immunotherapies, including ICIs, CAR T-cells, and DC vaccines, represent promising avenues for MPM treatment.
- Addressing chemo-resistance and late-stage diagnosis requires innovative therapeutic approaches.
- Careful clinical trial design is essential to advance immunotherapy for MPM.
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