Malignant pleural mesothelioma (MPM) is a rare but very aggressive cancer of the thin tissue layer (pleura) covering the lungs. The development of MPM is strongly linked to previous exposure to the fibrous mineral asbestos, which has been widely used until the 1980s, in particular in the building industry. Although patients are generally eligible to undergo multimodality treatment approaches consisting of combinations of surgery, chemotherapy, radiotherapy, and recently also immunotherapy, the prognosis for MPM remains rather dismal, with median overall survival reaching around 24 months.
Several factors are contributing to this poor [ prognosis for MPM ], one of them being the difficulties associated with diagnosing MPM, which is difficult even for experienced pathologists, but even more so for general practitioners, who often only see a handful of cases during their career. Another reason for the poor [ prognosis for MPM ] is the intrinsic drug resistance of MPM, which is reflected in the fact that only approximately 40% of patients respond to the current standard chemotherapy of platinum + pemetrexed/gemcitabine. Furthermore, while surgical removal of the tumour is often part of the treatment concept, relatively early local recurrence within 12 months of tumour resection is a frequent issue that decreases the prognosis of patients and requires additional treatments to be added.1
Hence, for a disease like MPM, which is challenging in every step from diagnosis over initial treatment to subsequent treatment of recurrent disease, specialised centres are needed in which the patients are treated with individual concepts based on the decision of multidisciplinary tumour boards consisting of experts of various specialties (oncology, pathology, surgery, radiology, radiooncology, pneumology).