Pleural Mesothelioma: The Importance of Working Together

Pleural mesothelioma (PM) is a rare and extremely aggressive neoplasm that originates from the pleural mesothelium and whose onset is mainly linked to exposure to asbestos. To date, PM cannot be attacked with truly effective therapies, and the average survival of affected patients is about 12–15 months from diagnosis. The incidence in Europe is expected to peak around 2025, due to the long latency that can elapse between exposure to asbestos fibers and the onset of the disease. Asbestos can be defined as non-mutagenic carcinogen: its biopersistent nanometric fibers are inhaled, reach the pleural space, and interact directly with cell receptors, causing their inappropriate activation and consequently, at the cellular level, an afinalistic proliferative response. Furthermore, it is known that chronic exposure to asbestos induces an immunosuppressive inflammatory response in the mesothelial microenvironment that contributes to neoplastic progression. In this very complex context, a multidisciplinary approach toward the disease is mandatory to optimize diagnostic strategies, to impair cancer progression, and to define more efficient therapeutic strategies, in other words, to personalize patients’ management and to improve their outcome.