Prise en charge du mésothéliome pleural malin en 2013

Malignant pleural mesothelioma (MPM) is a rare and aggressive tumor, secondary to occupational asbestos exposure. Clinical and radiological signs are unspecific. The diagnosis of MPM is based on histology on biopsies best obtained by thoracoscopy. Prophylactic irradiation of chest scars and drains is validated by French guidelines. Surgery, extrapleural pneumonectomy or pleurectomy/decortication, is not recommended outside a clinical trial. Firstline chemotherapy with pemetrexed remains the standard treatment. Bevacizumab is currently tested in an ongoing randomized phase 3 trial, MAPS, ending in late 2013.