Mesothelioma

Rare Cancer

Category: 呼吸器ICD-10: C45

Overview

Mesothelioma is a malignant tumor of the mesothelial lining, primarily caused by asbestos exposure with a latency period of 20-50 years. Pleural mesothelioma accounts for about 80% of cases. Prognosis remains poor with median survival of 12-18 months.

Symptoms

Dyspnea and chest pain from pleural effusion are the most common initial symptoms. Weight loss, fatigue, and persistent chest wall pain develop as the disease progresses.

Diagnosis

Chest CT reveals pleural thickening and effusion, and thoracoscopic biopsy provides tissue for definitive diagnosis. Immunohistochemistry for calretinin and WT-1 confirms mesothelial origin.

Treatments

Resectable cases undergo pleurectomy/decortication with adjuvant chemotherapy. Unresectable disease is treated with cisplatin plus pemetrexed as first-line chemotherapy. Nivolumab plus ipilimumab is now approved as a new standard treatment option.

Latest Research & Approaches

The CheckMate 743 trial demonstrated superior overall survival with nivolumab plus ipilimumab versus chemotherapy. Research targeting BAP1 loss and NF2 alterations is ongoing.

Sources & References

NCI - Mesothelioma Treatment
American Cancer Society - Mesothelioma
NCCN Guidelines: Malignant Pleural Mesothelioma