Department of Experimental Medicine and Surgery, Policlinico Tor Vergata University, Rome, Italy.
Oncology (Williston Park). 2012 Dec;26(12):1164-75.
Malignant pleural mesothelioma (MPM) is a highly severe primary tumor of the pleura mainly related to exposure to asbestos fibers. The median survival after symptom onset is less than 12 months. Conventional medical and surgical therapies--either as single lines or combined--are not wholly effective. No universally accepted guidelines have yet been established for patient selection and the use of therapeutic strategies. In addition, retrospective staging systems have proved inadequate at improving therapeutic outcomes. Therapy is currently guided by gross tumor characteristics and patient features; however, these seem less accurate than the biological fingerprint of the tumor. A number of clinical prognostic factors have been considered in large multicenter series and independently validated. A series of novel biomarkers can predict the evolution of the disease. Here we summarize the principal and novel factors that influence prognosis and are thus potentially useful for selecting patients for targeted therapy.
恶性胸膜间皮瘤（MPM）是一种高度严重的胸膜原发性肿瘤，主要与暴露于石棉纤维有关。症状出现后的中位生存时间不到 12 个月。传统的医疗和手术治疗——无论是单一疗法还是联合疗法——都不是完全有效的。对于患者的选择和治疗策略的使用，尚未建立普遍接受的指南。此外，回顾性分期系统已被证明不能改善治疗效果。目前的治疗方法是根据肿瘤的大体特征和患者特征来指导的；然而，这些特征似乎不如肿瘤的生物学特征准确。在大型多中心系列研究和独立验证中，已经考虑了许多临床预后因素。一系列新的生物标志物可以预测疾病的演变。在这里，我们总结了主要的和新的影响预后的因素，因此对选择患者进行靶向治疗可能有用。
