Abstract
After a wide review of the role of palliative chemotherapy in non-resectable malignant pleural mesothelioma, this chapter illustrates promising future research directions. The role of thymidylate synthase and of excision repair crosscomplementation group 1 expression has been found to significantly correlate with prognosis. Several approaches to improve the efficacy of platinum salts are being explored. The search for novel antifolates (i.e. pralaxate and GW1843) as well as thymidilate synthase (i.e. plevitrexed and BGC 945) is ongoing. The platinum-based regimens could benefit from the addition of bevacizumab and amatuximab, monoclonal antibody against the vascular endothelial growth factor and mesothelin, respectively.
Keywords: Chemotherapy, maintenance therapy, pemetrexed, raltitrexed.