Department of Medical Oncology, West German Cancer Center, University Hospital Essen, University Duisburg-Essen, Essen, North Rhine-Westphalia, Germany.
Curr Opin Oncol. 2014 Mar;26(2):171-81. doi: 10.1097/CCO.0000000000000053.
Malignant pleural mesothelioma (MPM) is a rare malignancy with limited therapeutic options and its incidence is still increasing in both Europe and the developing nations. Prognosis of MPM patients is poor even if the median survival durations have been slightly improved after the introduction of the up-to-date chemotherapy combination with pemetrexed and cisplatin. There is a continuing unmet need to develop better systemic treatment for this disease, but the rarity of the tumor type creates formidable challenges in clinical trial research.
Better understanding of the molecular machinery of MPM leads to the design and synthesis of novel compounds targeted against pathways identified as crucial for MPM cell proliferation and metastasis. Most efforts aim at improving standard first-line therapy, or developing effective second-line treatments. Several classes of drugs are currently being explored either in combination with cisplatin and pemetrexed or as single agent for relapsed or progressive MPM.
This review focuses on several ongoing or recently completed clinical trials investigating novel, promising agents as first-line or second-line therapy for advanced MPM.
目的综述：恶性胸膜间皮瘤（MPM）是一种罕见的恶性肿瘤，治疗选择有限，其发病率在欧洲和发展中国家仍在上升。即使在引入培美曲塞和顺铂的最新化疗联合方案后，中位生存时间略有改善，但 MPM 患者的预后仍然很差。对于这种疾病，仍需要开发更好的系统治疗方法，但肿瘤类型的罕见性给临床试验研究带来了巨大的挑战。
最新发现：对 MPM 分子机制的更好理解导致了针对被确定为对 MPM 细胞增殖和转移至关重要的途径的新型化合物的设计和合成。大多数努力旨在改善标准的一线治疗，或开发有效的二线治疗。目前正在探索几类药物，要么与顺铂和培美曲塞联合使用，要么作为二线治疗复发性或进展性 MPM 的单一药物。
总结：本文综述了几项正在进行或最近完成的临床试验，这些试验研究了新型、有前途的药物作为晚期 MPM 的一线或二线治疗。
