[Malignant pleural mesothelioma. II. Modern therapeutic concepts]

In the second part of our review of malignant pleural mesothelioma, we reviewed current concepts of the treatment of this highly malignant disease. Although there are still advocates for the use of best supportive care to the treatment of these patients, the accumulated evidence favorizes the combined modality approach. Surgery, followed by postoperative external beam radiotherapy (or intraoperative radiotherapy), offers increased response rates and median survival as well as a higher percentage of patients surviving a two-year period. Although widely tested, both single-agent and multiple-agent chemotherapy did not succeed in transmitting high response rates into an improved survival. New treatment approaches are needed to improve poor survival in patients with malignant pleural mesothelioma.