Tumor Immune Microenvironment and Genetic Alterations in Mesothelioma

Malignant pleural mesothelioma (MPM) is a rare and fatal disease of the lining. Up to 80% MPM cases are linked asbestos exposure. Even though its use has been banned in industrialized countries, continue increase. lethal cancer, with very little survival improvements last years, mirroring limited therapeutic advances. Platinum-based chemotherapy combination pemetrexed surgery standard care, but prognosis still unacceptably poor median overall approximately 12 months. The genomic landscape widely characterized showing low mutational burden impairment tumor suppressor genes. Among them, BAP1 BLM present as germline inactivation small subset patients increases predisposition tumorigenesis. Other studies have demonstrated high frequency mutations DNA repair Many therapy approaches targeting these alterations emerged under evaluation clinic. High-throughput technologies allowed detection more complex molecular events, like chromotripsis revealed different transcriptional programs for each histological subtype. Transcriptional analysis also paved way study tumor-infiltrating cells, thus shedding lights on crosstalk between cells microenvironment. microenvironment indeed crucial pathogenesis outcome this disease; it by an inflammatory response exposure, involving variety chemokines suppressive immune such M2-like macrophages regulatory T cells. Another important feature dysregulation microRNA expression, being frequently cancer development drug resistance. This review will give detailed overview all above mentioned features order improve understanding new strategies.