Molecular-Targeted Therapy For Malignant Mesothelioma

Malignant pleural mesothelioma (MPM) is an intractable disease associated with asbestos exposure, and the number of affected patients will increase in the coming decades. The clinical outcome associated with current treatments is unsatisfactory, and the chemotherapy regimen for mesothelioma has remained unchanged for the past 10 years. Emerging molecular-targeted therapies are a novel way to treat other types of tumors and have been shown to drastically improve clinical response and patient prognosis. Some of these targeted agents had promising effects on MPM at the preclinical level and in various clinical trials that have been conducted over the last decade. Contrary to our expectations, results from the majority of these studies were disappointing and many were terminated at an early stage. No useful predictive or prognostic biomarkers were identified for mesothelioma treatment. Nevertheless, some novel strategies involving focal adhesion kinase inhibitors and immune checkpoint targeting agents showed some antitumor effects. In this article, we review the outcomes of previous clinical trials using molecular-targeted agents and discuss several hurdles that need to be overcome, which hopefully will contribute to a better understanding of this rare malignancy.