Mesothelioma is an unusual and highly malignant cancer affecting the serous membranes, arising from the parietal pericardium, which surrounds the heart and lungs. It usually occurs around the age of 50 and is more common in women. It is treated by surgical removal and chemotherapy. Survival is less than 10% after a few years.
As mesothelioma is largely diagnosed postoperatively, the treatments are mostly palliative. Most mesothelioma patients are treated with surgery if the tumor is small, and chemotherapy or radiation therapy if the tumor is more advanced. Mesothelioma tends to remain a fatal cancer with a six-month survival rate of approximately 20%.\n
The major signs of mesothelioma and its precursor, pleural malignancy are coughing up blood, chest pain, dyspnea and coughing up blood with blood. However, the symptoms of mesothelioma vary greatly. Tumor size, location and metastatic spread can also play a role in determining the specific signs and symptoms of the cancer.
Survival time for mesothelioma patient is mostly found to be correlated with both the stage at diagnosis and the patient's age; stage 5s, however, show the longest survival.
This pooled analysis of clinical trials show that pembrolizumab has the potential to be an effective and safe treatment for patients with advanced MPM. These data should help guide treatment decisions for patients with MPM who have undergone prior systemic therapy and will aid in developing new treatments for this disease once new agents and targeted therapies become available.
Both radiation and asbestos exposure are risk factors for mesothelioma. Other potentially implicated agents include many drugs, some of which have also been used in therapy for cancer, and environmental chemicals such as asbestos. Mesothelioma is a disease that develops in a very diverse group of patients, and most physicians have never seen a case. More importantly, many people are unaware of their own elevated risk of developing this disease. Mesothelioma has a high mortality rate, and is often diagnosed too late to produce a cure.
While the number of new cases occurring in the US is expected to be higher than those in Europe, an equivalent number of people will develop this malignancy and it is not clear whether the disease burden will become greater in the US or not. The difference in survival between whites and blacks cannot be explained by increased incidence of the malignancy among whites. It would be more informative to determine the cause of these differences and their relation to racial disparities in treatment or survival.
Most patients with mesothelioma are cured by surgery or chemotherapy. While surgical options are most frequently curative at early stages of disease, chemotherapy can prolong survival in most patients with resectable and advanced disease.
The use of pembrolizumab for treatment of advanced mesothelioma appears to be safe and results in significant improvement in survival. Further research is needed to explore the therapeutic benefit of pembrolizumab for treatment of malignant pleural mesothelioma.
The rate of dissemination and survival may be influenced by a number of factors, such as patient, tumor histological and histological grade type, tumor stage, and the ability of the tumor microenvironment to support proliferation and metastatic dissemination. The presence of occult disease in an early Tumor stage (Stage I or II) will increase the likelihood of spread, and the ability of tumors to metastasize must be considered when making patient treatment programs, which require adequate patient selection to optimize outcomes after surgery.