Therapy for malignant pleural mesothelioma

Abstract

Malignant mesotheliomas, highly aggressive neoplasms arising primarily from the surface serosal cells of the pleural, peritoneal, and pericardial cavities, are caused primarily from exposure to asbestos fibers. Recent investigations have also implicated simian virus 40 (SV40) and genetic predisposition in the etiology of some malignant mesothelioma. The disease is characterized by a long latency from the time of exposure to asbestos to the onset of disease. Early evidence provided by karyotypic analysis supports the theory that multiple somatic genetic events are required for tumorigenic conversion of a normal mesothelial cell. Although a specific chromosomal change is not shared by all malignant mesotheliomas, several prominent sites of chromosomal loss have been identified in this malignancy. Tumor suppressor genes (TSGs) residing in these deleted chromosomal regions may be responsible for the tumorigenic conversion of mesothelial cells, and recent studies have begun to identify the specific TSGs that contribute to the development and progression of malignant mesothelioma. Here we review the clinical aspects of this malignancy, focusing on etiology, pathology, epidemiology, symptoms, diagnosis, imaging methods, and treatment. © 2006 Springer Science+Business Media, Inc.