Emerging Drug Therapies for Mesothelioma

The systemic chemotherapy combination of cisplatin and pemetrexed has been the mesothelioma standard of care for well over a decade. This regimen has only achieved a disappointing overall median survival of about 1 year. Improved survival has been reported when systemic chemotherapy is combined with surgery and radiotherapy, and for using localized chemotherapy in some cases. The choice of mesothelioma treatment often depends on the anatomical location, histologic subtype, and disease progression. Several experimental drugs have also been investigated in mesothelioma, often with limited positive results that maintain the reputation of mesothelioma as a graveyard for drug development. This chapter will review the use of drug treatment in mesothelioma and highlight emerging experimental drug therapies in clinical trials. Experimental drugs for mesothelioma include inhibitors for checkpoints, epidermal growth factor, AXL, focal adhesion kinase, vascular endothelial growth factor, poly-ADP-ribose-polymerase, and hippo signaling.