LUNG AND MEDIASTINUM: Edited by Robert PirkerSystemic treatment of malignant pleural mesothelioma: new agents in clinical trials raise hope of relevant improvementsChristoph, Daniel C.; Eberhardt, Wilfried E.E.Author Information Department of Medical Oncology, West German Cancer Center, University Hospital Essen, University Duisburg-Essen, Essen, North Rhine-Westphalia, Germany Correspondence to Daniel C. Christoph, Department of Medical Oncology, West German Cancer Center, University Hospital Essen, University Duisburg-Essen, Hufelandstrasse 55, 45147 Essen, North Rhine-Westphalia, Germany. Tel: +49 201 723 85033; fax: +49 201 723 5768; e-mail: firstname.lastname@example.org Current Opinion in Oncology: March 2014 - Volume 26 - Issue 2 - p 171-181 doi: 10.1097/CCO.0000000000000053 Buy Metrics Abstract Purpose of review Malignant pleural mesothelioma (MPM) is a rare malignancy with limited therapeutic options and its incidence is still increasing in both Europe and the developing nations. Prognosis of MPM patients is poor even if the median survival durations have been slightly improved after the introduction of the up-to-date chemotherapy combination with pemetrexed and cisplatin. There is a continuing unmet need to develop better systemic treatment for this disease, but the rarity of the tumor type creates formidable challenges in clinical trial research. Recent findings Better understanding of the molecular machinery of MPM leads to the design and synthesis of novel compounds targeted against pathways identified as crucial for MPM cell proliferation and metastasis. Most efforts aim at improving standard first-line therapy, or developing effective second-line treatments. Several classes of drugs are currently being explored either in combination with cisplatin and pemetrexed or as single agent for relapsed or progressive MPM. Summary This review focuses on several ongoing or recently completed clinical trials investigating novel, promising agents as first-line or second-line therapy for advanced MPM. © 2014 Lippincott Williams & Wilkins, Inc.