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Immunotherapy, the Promise for Future of Mesothelioma Treatment?

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Mesothelioma

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Abstract

Due to occupational asbestosis exposure, malignant pleural mesothelioma (MPM) incidence has increased continuously for the last 30 years, a plateau being anticipated around 2030. Molecular carcinogenesis of MPM involves NF2, WT1 RASSF1, p16, and BAP1 tumor-suppressor genes alterations, regulating apoptosis, cell invasion and motility, cell division, chromatin remodeling, and DNA repair control. In selected patients, debulking surgery (pleurectomy–decortication) provided unsatisfactory long-term results. First-line chemotherapy was based on a doublet of pemetrexed and cisplatin for 15 years. Addition of the monoclonal antibody bevacizumab (Avastin®), targeting vascular endothelial growth factor (VEGF), has been shown to improve overall survival (to nearly 19 months), without quality of life (QoL) alteration, in the French Intergroup-sponsored randomized Mesothelioma Avastin Cisplatin Pemetrexed Study (MAPS) phase 3 trial. The emergence of immune check-point inhibitors (ICI) in cancer treatment prompted to study whether (1) MPM could be considered as “hot” tumors regarding inflammatory infiltration, (2) ICI could play a role in MPM treatments, and (3) what could be the predictors of ICI efficacy in MPM. Convergent preliminary results currently support that, indeed, ICI could represent a major advance in future MPM standard care and are reviewed in this chapter.

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Author information

Authors and Affiliations

  1. Thoracic Oncology Department and Early Phase Unit CIC1425, University Hospital Bichat-Claude Bernard, Paris, France

    S. Brosseau, V. Gounant & G. Zalcman

  2. Faulty of Medicine, University Paris-Diderot, Paris, France

    S. Brosseau & G. Zalcman

  3. Institut National de la Santé et de la Recherche Médicale (INSERM) U830, “Genetics and Biology of Cancers” Institut Curie Research Center, Paris, France

    G. Zalcman

Authors
  1. S. Brosseau
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  2. V. Gounant
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  3. G. Zalcman
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Correspondence to G. Zalcman .

Editor information

Editors and Affiliations

  1. Department of Medical Oncology, Humanitas Gavazzeni Hospital, Bergamo, Italy

    Giovanni Luca Ceresoli

  2. Scientific Direction, Humanitas Gavazzeni Hospital, Bergamo, Italy

    Emilio Bombardieri

  3. Department of Oncology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy

    Maurizio D'Incalci

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Brosseau, S., Gounant, V., Zalcman, G. (2019). Immunotherapy, the Promise for Future of Mesothelioma Treatment?. In: Ceresoli, G., Bombardieri, E., D'Incalci, M. (eds) Mesothelioma. Springer, Cham. https://doi.org/10.1007/978-3-030-16884-1_20

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  • DOI: https://doi.org/10.1007/978-3-030-16884-1_20

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-16883-4

  • Online ISBN: 978-3-030-16884-1

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