Malignant pleural mesothelioma (MPM): clinical guidelines for diagnosis, treatment and follow-up

Malignant mesothelioma is an aggressive tumor of the serosa, arising from the serosal lining of various cavities. It most commonly affects the pleura and, to a lesser extent, the peritoneum (15-20%). Mesothelioma of the pericardium and tunica vaginalis testis is extremely rare. Once considered a rare disease, its incidence is increasing worldwide, likely due to widespread exposure to asbestos. The initial cases occurred in individuals who were directly exposed to asbestos in their work, particularly in mining or milling. Malignant pleural mesothelioma is a highly progressive malignancy, with a median survival of up to 26 months with the use of new therapeutic agents. A major breakthrough in treatment came with the introduction of pemetrexed in combination with platinum-based compounds, followed by combinations with VEGF inhibitors. The new standard of care is the combination of nivolumab with ipilimumab, which has demonstrated significant clinical benefits in recent trials.