Pellegrini I, Sibille A, Paulus A, Vaillant F, Radermecker M A, Corhay J L, Louis R, Duysinx B
Service de Pneumologie, CHU Liège, Belgique.
Service de Chirurgie cardiovasculaire, CHU Liège, Belgique.
Rev Med Liege. 2019 Dec;74(12):627-632.
Malignant pleural mesothelioma is a rare disease originating from mesothelial cells of the pleura and is related to asbestos exposure. The tumor is generally extended at the time of diagnosis and the treatment consists of a systemic palliative therapy. Radical approach is limited to very selected patients and is performed in expert centers but without validated schema. Radiotherapy alone is mainly used in palliative intent. Platinum-based chemotherapy in association with pemetrexed is the frontline standard of care and provides a 12-month overall survival. The addition of bevacizumab, an antiangiogenic drug, shows an improvement in median survival. To date, there is no second-line treatment approved for this disease and therefore inclusion in trials is recommended. Currently, various studies are investigating target therapy, immunotherapy and intrapleural perioperative treatment.
恶性胸膜间皮瘤是一种起源于胸膜间皮细胞的罕见疾病，与接触石棉有关。该肿瘤在诊断时通常已扩散，治疗包括全身姑息治疗。根治性方法仅限于极少数经过挑选的患者，且在专家中心进行，但尚无经过验证的方案。单纯放疗主要用于姑息治疗目的。铂类化疗联合培美曲塞是一线标准治疗方案，可提供12个月的总生存期。添加抗血管生成药物贝伐单抗可使中位生存期有所改善。迄今为止，尚无该疾病的二线治疗方案获批，因此建议纳入试验。目前，各种研究正在探索靶向治疗、免疫治疗和胸膜内围手术期治疗。
