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Le Mésothéliome Pleural Malin

J. Margery, D. Planchard
Published 2014 · Medicine

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RésuméLe mésothéliome pleural malin (MPM) est une tumeur rare et agressive, souvent consécutive à une exposition professionnelle à l’amiante. La symptomatologie clinique et radiologique est aspécifique. Le diagnostic est apporté par l’histologie à partir de biopsies pleurales obtenues par thoracoscopie. L’irradiation des orifices chirurgicaux diagnostiques est validée par les recommandations francophones. La chirurgie par pleuropneumonectomie élargie ou par pleurectomie/décortication n’est pas recommandée en dehors d’un essai clinique. La chimiothérapie par la combinaison pemetrexed-cisplatine est le traitement de référence du MPM. Le bevacizumab est évalué dans l’essai de phase III MAPS dont les 445 inclusions se sont terminées en décembre 2013.AbstractMalignant 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 and 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 was tested in an randomized phase 3 trial, MAPS, until December 2013.
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