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Crit Rev Oncol Hematol. 2016 Nov;107:20-32. doi: 10.1016/j.critrevonc.2016.08.011. Epub 2016 Sep 1.

The resistance related to targeted therapy in malignant pleural mesothelioma: Why has not the target been hit yet?

Author information

  • 1Section of Medical Oncology, Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy.
  • 2Phase I- Early Clinical Trials Unit, Oncology Department and Multidisciplinary Oncology Center Antwerp (MOCA), Antwerp University Hospital, Edegem, Belgium.
  • 3Department of Medical, Oral and Biotechnological Sciences, University "G. D'Annunzio", Chieti, Italy.
  • 4Section of Medical Oncology, Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy. Electronic address: antonio.russo@usa.net.

Abstract

Malignant pleural mesothelioma (MPM) is an aggressive tumor of the pleura with a poor prognosis. The most active first-line regimens are platinum compounds and pemetrexed. There is no standard second-line treatment in MPM. Advances in the understanding of tumor molecular biology have led to the development of several targeted treatments, which have been evaluated in clinical trials. Unfortunately none of the explored targeted treatments can currently be recommended as routine treatment in MPM. We reviewed the biological pathways involved in MPM, the clinical trials about targeted therapy, and possible related mechanisms of resistance. We suggest that specific genetic markers are needed as targets of selective therapy. By this way the selection of patients based on the molecular profile may facilitate a therapeutic strategy that allows the use of the most appropriate drug for each patient.

KEYWORDS:

Mesothelioma; Pleura; Resistance; Targeted therapy

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