Mesothelioma is a rare malignant tumor which grows on the mesothelial surface of coelomic cavities including tunica pleura, vaginalis, peritoneum, and pericardium. Malignant pleural mesothelioma (MPM) is the commonest form of mesothelioma. One of the major causes of MPM is inhalational exposure to asbestos.

Asbestos is a set of silicate minerals found in nature, and can be classified into serpentine (e.g. chrysotile) and amphibole (e.g. amosite, crocidolite, tremolite, anthophyllite and actionolite). Asbestos was frequently used in construction and different industries, making MPM an occupational disease with male predominance.

The incidence rate of MPM in Australia, Europe and Japan is about 29, 20 and 7 per million, respectively. The average age-standardized incidence rate (ASR) of mesothelioma increased from 2.4 to 3.4 per million in 2004-2008 to 2009-2017. Therefore, any apparent reduction in number of cases is not expected in the near future, unless it is dealt with.

Clinically, the combination of cisplatin and pemetrexed has become the cornerstone combination chemotherapy in managing advanced MPM. It is well-known that inter- and intra-tumoral heterogeneity in MPM patients is very high, which would limit the benefits of existing treatment options, including targeted therapy and immunotherapy. As such, extensive researches on various agents/combinations for treating MPM are urgently needed.

Drug resistance is inevitable. Most MPM patients are either naturally resistant or acquire resistance to cisplatin/pemetrexed treatment, which results in a mean overall survival of around 12 months and a median progression free survival of less than 6 months. Patients will move to second line treatment if first line chemotherapy fails. As such, it is important to identify the sensitive and resistant genes in new drug treatments so as to achieve better prognosis during the translation of novel treatments to salvage therapies for chemoresistant MPM patients.

The goal of this Research Topic is to study malignant pleural mesothelioma treatment in basic research with the scope being including the latest developments in malignant pleural mesothelioma treatment and underlying resistant mechanisms.

The Research Topic will focus on basic research in MPM treatment with the scope being, to gather a comprehensive list of articles related to MPM, including the latest developments in MPM treatment and underlying resistant mechanisms.

We welcome the submission of Original Research Articles, Reviews and Mini-reviews, including but not limited to the following topics:
1) Novel therapies including but not limited to chemotherapy, metabolic therapy, immunotherapy, combination of drugs.
2) Novel drug resistance in various therapeutics/therapeutic approaches

Prof. Steve Mutsaers is currently doing some consultancy work for Neuroscientific Pharmaceuticals, a Western Australian biotech. He also holds a small number of shares in this company. He also holds a small number of shares in BARD1 Life Sciences, an Australian Biotech.

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