Need for randomized clinical trials testing targeted therapies in malignant pleural mesothelioma

Malignant Pleural Mesothelioma (MPM) is a rare and aggressive tumour affecting the internal lining of the pleura. It is characterized by a poor prognosis and patients normally do not live longer than 12 months. The main cause of this disease is known to be asbestos, although there are some studies pointing at the involvement of Simian virus 40 in its pathogenesis. Other factors that may be involved in the pathogenesis include environmental exposure to erionite, fluoro-edenite and ionizing radiation as well as exposure to ceramic fibres [1,5]. The current standard treatment is the combination of cisplatin with pemetrexed [6,7]. However the average survival for this tumour still remains around 1 year. Hence there is an urgent need for a better understanding of the underlying biology of the disease to identify new actionable targets and improve patients’ outcomes. In fact, no targeted therapies have been approved so far for the treatment of the disease. Using data collected from the literature on the very few randomized MPM clinical trials available, we performed a meta-analysis with the aim of investigating the efficacy of targeted therapies in MPM.