TY - JOUR T1 - Update on biology and management of mesothelioma JF - European Respiratory Review JO - EUROPEAN RESPIRATORY REVIEW DO - 10.1183/16000617.0226-2020 VL - 30 IS - 159 SP - 200226 AU - Rachelle Asciak AU - Vineeth George AU - Najiib M. Rahman Y1 - 2021/03/31 UR - http://err.ersjournals.com/content/30/159/200226.abstract N2 - Malignant pleural mesothelioma is an aggressive, incurable cancer that is usually caused by asbestos exposure several decades before symptoms arise. Despite widespread prohibition of asbestos production and supply, its incidence continues to increase. It is heterogeneous in its presentation and behaviour, and diagnosis can be notoriously difficult. Identification of actionable gene mutations has proven challenging and current treatment options are largely ineffective, with a median survival of 10–12 months.However, the past few years have witnessed major advances in our understanding of the biology and pathogenesis of mesothelioma. This has also revealed the limitations of existing diagnostic algorithms and identified new treatment targets.Recent clinical trials have re-examined the role of surgery, provided new options for the management of associated pleural effusions and heralded the addition of targeted therapies. The increasing complexity of mesothelioma management, along with a desperate need for further research, means that a multidisciplinary team framework is essential for the delivery of contemporary mesothelioma care.This review provides a synthesised overview of the current state of knowledge and an update on the latest research in the field.Despite a better understanding of the pathogenesis of malignant pleural mesothelioma, effective treatment that prolongs survival significantly is lacking. Ongoing research may identify select patient groups that may benefit from surgical treatment. https://bit.ly/3k16J9O ER -