TY - JOUR
T1 - Mesothelioma
T2 - Scientific clues for prevention, diagnosis, and therapy
AU - Carbone, Michele
AU - Adusumilli, Prasad S.
AU - Alexander, H. Richard
AU - Baas, Paul
AU - Bardelli, Fabrizio
AU - Bononi, Angela
AU - Bueno, Raphael
AU - Felley-Bosco, Emanuela
AU - Galateau-Salle, Francoise
AU - Jablons, David
AU - Mansfield, Aaron S.
AU - Minaai, Michael
AU - de Perrot, Marc
AU - Pesavento, Patricia
AU - Rusch, Valerie
AU - Severson, David T.
AU - Taioli, Emanuela
AU - Tsao, Anne
AU - Woodard, Gavitt
AU - Yang, Haining
AU - Zauderer, Marjorie G.
AU - Pass, Harvey I.
N1 - Publisher Copyright:
© 2019 American Cancer Society
PY - 2019/9/1
Y1 - 2019/9/1
N2 - Mesothelioma affects mostly older individuals who have been occupationally exposed to asbestos. The global mesothelioma incidence and mortality rates are unknown, because data are not available from developing countries that continue to use large amounts of asbestos. The incidence rate of mesothelioma has decreased in Australia, the United States, and Western Europe, where the use of asbestos was banned or strictly regulated in the 1970s and 1980s, demonstrating the value of these preventive measures. However, in these same countries, the overall number of deaths from mesothelioma has not decreased as the size of the population and the percentage of old people have increased. Moreover, hotspots of mesothelioma may occur when carcinogenic fibers that are present in the environment are disturbed as rural areas are being developed. Novel immunohistochemical and molecular markers have improved the accuracy of diagnosis; however, about 14% (high-resource countries) to 50% (developing countries) of mesothelioma diagnoses are incorrect, resulting in inadequate treatment and complicating epidemiological studies. The discovery that germline BRCA1-asssociated protein 1 (BAP1) mutations cause mesothelioma and other cancers (BAP1 cancer syndrome) elucidated some of the key pathogenic mechanisms, and treatments targeting these molecular mechanisms and/or modulating the immune response are being tested. The role of surgery in pleural mesothelioma is controversial as it is difficult to predict who will benefit from aggressive management, even when local therapies are added to existing or novel systemic treatments. Treatment outcomes are improving, however, for peritoneal mesothelioma. Multidisciplinary international collaboration will be necessary to improve prevention, early detection, and treatment.
AB - Mesothelioma affects mostly older individuals who have been occupationally exposed to asbestos. The global mesothelioma incidence and mortality rates are unknown, because data are not available from developing countries that continue to use large amounts of asbestos. The incidence rate of mesothelioma has decreased in Australia, the United States, and Western Europe, where the use of asbestos was banned or strictly regulated in the 1970s and 1980s, demonstrating the value of these preventive measures. However, in these same countries, the overall number of deaths from mesothelioma has not decreased as the size of the population and the percentage of old people have increased. Moreover, hotspots of mesothelioma may occur when carcinogenic fibers that are present in the environment are disturbed as rural areas are being developed. Novel immunohistochemical and molecular markers have improved the accuracy of diagnosis; however, about 14% (high-resource countries) to 50% (developing countries) of mesothelioma diagnoses are incorrect, resulting in inadequate treatment and complicating epidemiological studies. The discovery that germline BRCA1-asssociated protein 1 (BAP1) mutations cause mesothelioma and other cancers (BAP1 cancer syndrome) elucidated some of the key pathogenic mechanisms, and treatments targeting these molecular mechanisms and/or modulating the immune response are being tested. The role of surgery in pleural mesothelioma is controversial as it is difficult to predict who will benefit from aggressive management, even when local therapies are added to existing or novel systemic treatments. Treatment outcomes are improving, however, for peritoneal mesothelioma. Multidisciplinary international collaboration will be necessary to improve prevention, early detection, and treatment.
KW - BRCA1-associated protein 1 (BAP1)
KW - asbestos
KW - cancer syndromes
KW - chromothripsis
KW - gene-environment interaction
KW - immunotherapy
KW - mesothelioma
UR - http://www.scopus.com/inward/record.url?scp=85068712177&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85068712177&partnerID=8YFLogxK
U2 - 10.3322/caac.21572
DO - 10.3322/caac.21572
M3 - Review article
C2 - 31283845
AN - SCOPUS:85068712177
SN - 0007-9235
VL - 69
SP - 402
EP - 429
JO - CA Cancer Journal for Clinicians
JF - CA Cancer Journal for Clinicians
IS - 5
ER -