Diagnostic and Therapeutic Pathway in Diffuse Malignant Peritoneal Mesothelioma

Autor: Shigeki Kusamura, Dario Baratti, Michele De Simone, Enrico Maria Pasqual, Luca Ansaloni, Daniele Marrelli, Manuela Robella, Fabio Accarpio, Mario Valle, Stefano Scaringi, Daniele Biacchi, Carmen Palopoli, Sergio Gazzanelli, Marcello Guaglio, Marcello Deraco
Jazyk: angličtina
Rok vydání: 2023
Předmět:
Zdroj: Cancers, Vol 15, Iss 3, p 662 (2023)
Druh dokumentu: article
ISSN: 2072-6694
DOI: 10.3390/cancers15030662
Popis: Diffuse malignant peritoneal mesothelioma (DMPM) is a rare form of mesothelioma that carries a very poor prognosis. The 5-year overall survival is about 20% (±5.9). Survival is optimal for patients suitable for cytoreductive surgery (CRS) with Hyperthermic Intraperitoneal Chemotherapy (HIPEC), with a median OS ranging from 34 to 92 months. However, selecting patients for surgery remains a complex task and requires a careful preoperative workup, rational analysis of prognostic profiles, and risk prediction models. Systemic chemotherapy could be offered: (1) in the adjuvant setting for high-risk patients; (2) for patients not eligible for CRS; and (3) for those with recurrent disease. It mainly includes the combination of Platin compound with Pemetrexed or immunotherapy. The biology of DMPM is still largely unknown. However, progress has been made on some fronts, such as telomere maintenance mechanisms, deregulation of apoptosis, tyrosine kinase pathways, and mutation of BRCA1-associated protein 1 (BAP1). Future perspectives should include translational research to improve our understanding of the disease biology to identify druggable targets. We should also clear the role of immune checkpoint inhibitors and investigate new locoregional technologies, such as pressurized intraperitoneal aerosol chemotherapy (PIPAC) or normothermic intraperitoneal chemotherapy (NIPEC).
Databáze: Directory of Open Access Journals
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