{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:42:32Z","timestamp":1787013752982,"version":"build-2736575974"},"reference-count":105,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T00:00:00Z","timestamp":1776902400000},"content-version":"vor","delay-in-days":22,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Thoracic Cancer"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Pleural mesothelioma (PM) is a rare and aggressive cancer arising from pleural mesothelial cells with a strong association to asbestos exposure. Among the diagnostic strategies available are noninvasive techniques including thoracic ultrasound (TUS), computed tomography (CT) scans, positron emission tomography (PET\u2010CT), and invasive procedures such as thoracoscopy and pleural biopsy. Accurate identification of the histological subtype is critical for tailoring treatment strategies. The standard treatment for unresectable PM has traditionally been chemotherapy, particularly platinum and pemetrexed. However, recent advances in translational clinical research, including immune checkpoint inhibitors (ICIs), are changing the therapeutic landscape, offering new opportunities for personalized treatment. The recent FDA approval of nivolumab and ipilimumab combination therapy as a first\u2010line treatment has significantly improved outcomes, especially for nonepithelioid subtypes. Ongoing studies are exploring additional immune\u2010targeted therapies such as VISTA, LAG\u20103, and dendritic cell\u2010based therapies. Early detection, refined biomarker identification, and a deeper understanding of the tumor microenvironment remain essential to improving PM prognosis and patient survival. This review provides a comprehensive exploration of the epidemiology, etiology, clinical manifestations, diagnostic approaches (including immunohistochemical and molecular markers), staging, and current treatment strategies for PM.<\/jats:p>","DOI":"10.1111\/1759-7714.70259","type":"journal-article","created":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T02:17:08Z","timestamp":1776997028000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Emerging Strategies in the Diagnosis and Treatment of Pleural Mesothelioma: An Overview"],"prefix":"10.1111","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-2902-3558","authenticated-orcid":false,"given":"Raffaella","family":"Pagliaro","sequence":"first","affiliation":[{"name":"Department of Translational Medical Sciences University of Campania Luigi Vanvitelli  Naples Italy"},{"name":"Unit of Respiratory Medicine \u201cLuigi Vanvitelli\u201d A.O. Dei Colli, Monaldi Hospital  Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5595-6849","authenticated-orcid":false,"given":"Beatrice","family":"Leonardi","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery Policlinico Vanvitelli\u2010University of Campania  Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela","family":"Schiattarella","sequence":"additional","affiliation":[{"name":"Department of Translational Medical Sciences University of Campania Luigi Vanvitelli  Naples Italy"},{"name":"Unit of Respiratory Medicine \u201cLuigi Vanvitelli\u201d A.O. Dei Colli, Monaldi Hospital  Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grazia","family":"Bergameo","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery Policlinico Vanvitelli\u2010University of Campania  Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5344-0056","authenticated-orcid":false,"given":"Carmine","family":"Picone","sequence":"additional","affiliation":[{"name":"Division of Radiology Istituto Nazionale Tumori IRCCS Fondazione Pascale\u2010IRCCS di Napoli.  Napoli Italy"},{"name":"Department of Medicine and Health Science Vincenzo Tiberio University of Molise  Campobasso Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adolfo Gallipoli","family":"D'Errico","sequence":"additional","affiliation":[{"name":"Lega Italiana Per la Lotta Contro i Tumori  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Filippo","family":"Scial\u00f2","sequence":"additional","affiliation":[{"name":"Department of Molecular Medicine and Medical Biotechnologies University of Naples Federico II  Naples Italy"},{"name":"CEINGE\u2010Biotechnologies Advances Scarl  Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabio","family":"Perrotta","sequence":"additional","affiliation":[{"name":"Department of Translational Medical Sciences University of Campania Luigi Vanvitelli  Naples Italy"},{"name":"Unit of Respiratory Medicine \u201cLuigi Vanvitelli\u201d A.O. Dei Colli, Monaldi Hospital  Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Luisa","family":"De Rimini","sequence":"additional","affiliation":[{"name":"Nuclear Medicine Unit AORN Ospedali Dei Colli  Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0628-613X","authenticated-orcid":false,"given":"Alfonso","family":"Fiorelli","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery Policlinico Vanvitelli\u2010University of Campania  Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Bianco","sequence":"additional","affiliation":[{"name":"Department of Translational Medical Sciences University of Campania Luigi Vanvitelli  Naples Italy"},{"name":"Unit of Respiratory Medicine \u201cLuigi Vanvitelli\u201d A.O. Dei Colli, Monaldi Hospital  Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,23]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/thoraxjnl\u20102013\u2010204161"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.36416\/1806\u20103756\/e20210129"},{"key":"e_1_2_8_4_1","volume-title":"The Latency Period of Mesothelioma Among a Cohort of British Asbestos Workers (1978\u20132005) British Journal of Cancer 109 7 1965 1973","author":"Frost G.","year":"2013"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1159\/000527971"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annonc.2021.11.005"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtho.2023.01.095"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1088\/0952\u20104746\/31\/1\/R01"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1038\/ng.912"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/jcp.22724"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.21037\/tlcr.2019.11.15"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13046\u2010024\u201003253\u2010y"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annonc.2022.01.074"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm13195837"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.21037\/jtd.2017.10.09"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.5493\/wjem.v14.i3.91739"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pneumo.2018.06.004"},{"key":"e_1_2_8_18_1","unstructured":"J. G.Ault R. W.Cole andC. G.Jensen \u201cVertebrate Lung Epithelial Cells Behavior of Crocidolite Asbestos During Mitosis in Living E\u2010Mail Alerts \u201d1995 http:\/\/cancerres.aacrjournals.org\/content\/55\/4\/792."},{"issue":"1","key":"e_1_2_8_19_1","first-page":"70","article-title":"Mesothelioma: A Review","volume":"12","author":"Mott F. E.","year":"2012","journal-title":"Ochsner Journal"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1152\/ajplung.1995.268.3.l471"},{"key":"e_1_2_8_21_1","unstructured":"A. V. S.JainandJ. M.Wallen \u201cMalignant Mesothelioma Continuing Education Activity \u201dhttps:\/\/www.ncbi.nlm.nih.gov\/books\/NBK519530\/?report=printable."},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598\u2010023\u201029001\u20104"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.3390\/biom15060828"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.17.3.495\u2010508.2004"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra050152"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers13164194"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm10112434"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10585\u2010015\u20109772\u20108"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1111\/1759\u20107714.70033"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.1111\/1759\u20107714.15022"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.1183\/20734735.0227\u20102023"},{"key":"e_1_2_8_32_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598\u2010025\u201013371\u2010y"},{"key":"e_1_2_8_33_1","doi-asserted-by":"publisher","DOI":"10.3390\/curroncol31090368"},{"key":"e_1_2_8_34_1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers16162860"},{"key":"e_1_2_8_35_1","doi-asserted-by":"publisher","DOI":"10.1177\/10732748241301901"},{"key":"e_1_2_8_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.rmed.2017.02.013"},{"key":"e_1_2_8_37_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12931\u2010024\u201002684\u20107"},{"key":"e_1_2_8_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtho.2024.03.007"},{"key":"e_1_2_8_39_1","doi-asserted-by":"publisher","DOI":"10.4103\/0256\u20104947.75771"},{"key":"e_1_2_8_40_1","doi-asserted-by":"publisher","DOI":"10.12659\/MSM.883759"},{"key":"e_1_2_8_41_1","doi-asserted-by":"publisher","DOI":"10.1183\/16000617.0063\u20102016"},{"key":"e_1_2_8_42_1","doi-asserted-by":"publisher","DOI":"10.1590\/S1516-89132007000600004"},{"key":"e_1_2_8_43_1","doi-asserted-by":"publisher","DOI":"10.1111\/resp.13659"},{"key":"e_1_2_8_44_1","doi-asserted-by":"publisher","DOI":"10.1136\/thx.2008.100545"},{"key":"e_1_2_8_45_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.ro.2023.06.001"},{"key":"e_1_2_8_46_1","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.00953\u20102019"},{"key":"e_1_2_8_47_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm13092600"},{"key":"e_1_2_8_48_1","doi-asserted-by":"publisher","DOI":"10.1136\/thoraxjnl\u20102021\u2010217959"},{"key":"e_1_2_8_49_1","doi-asserted-by":"publisher","DOI":"10.3390\/jor3040020"},{"key":"e_1_2_8_50_1","doi-asserted-by":"publisher","DOI":"10.21037\/jtd.2019.03.86."},{"key":"e_1_2_8_51_1","doi-asserted-by":"publisher","DOI":"10.21037\/atm.2017.03.41"},{"key":"e_1_2_8_52_1","doi-asserted-by":"publisher","DOI":"10.1109\/ICECCE49384.2020.9179443"},{"key":"e_1_2_8_53_1","doi-asserted-by":"publisher","DOI":"10.21037\/jtd\u201023\u2010611"},{"key":"e_1_2_8_54_1","doi-asserted-by":"publisher","DOI":"10.18632\/oncotarget.17910"},{"key":"e_1_2_8_55_1","doi-asserted-by":"publisher","DOI":"10.1177\/15330338251341053"},{"key":"e_1_2_8_56_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471\u20102105\u201016\u2010S9\u2010S3"},{"key":"e_1_2_8_57_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41379\u2010021\u201000850\u20106"},{"key":"e_1_2_8_58_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.xcrm.2023.101198"},{"key":"e_1_2_8_59_1","doi-asserted-by":"publisher","DOI":"10.1097\/MCP.0000000000000967"},{"key":"e_1_2_8_60_1","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2024.1500449"},{"key":"e_1_2_8_61_1","doi-asserted-by":"publisher","DOI":"10.21037\/jtd.2018.04.31"},{"key":"e_1_2_8_62_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2016.12.004"},{"key":"e_1_2_8_63_1","unstructured":"R.Ammendola G.Guerra M.Parisi et\u00a0al. \u201cExpression of Formyl\u2010Peptide Receptors in Human Lung Carcinoma \u201d35 no.5(2015):2769\u20132774."},{"key":"e_1_2_8_64_1","doi-asserted-by":"publisher","DOI":"10.1038\/bjc.2017.22"},{"key":"e_1_2_8_65_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.lungcan.2023.107360"},{"key":"e_1_2_8_66_1","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2023.1148798"},{"key":"e_1_2_8_67_1","doi-asserted-by":"publisher","DOI":"10.37349\/etat.2020.00028"},{"key":"e_1_2_8_68_1","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2023.1136049"},{"key":"e_1_2_8_69_1","doi-asserted-by":"publisher","DOI":"10.1097\/JTO.0b013e31820db125"},{"key":"e_1_2_8_70_1","doi-asserted-by":"publisher","DOI":"10.2353\/jmoldx.2010.090169"},{"key":"e_1_2_8_71_1","doi-asserted-by":"publisher","DOI":"10.1158\/2159\u20108290.CD\u201018\u20100804"},{"key":"e_1_2_8_72_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12885\u2010019\u20105652\u2010y"},{"key":"e_1_2_8_73_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11523\u2010022\u201000900\u20102"},{"key":"e_1_2_8_74_1","doi-asserted-by":"publisher","DOI":"10.1038\/ng.3520"},{"key":"e_1_2_8_75_1","doi-asserted-by":"publisher","DOI":"10.21037\/jxym\u201020\u201079"},{"key":"e_1_2_8_76_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtho.2022.04.008"},{"key":"e_1_2_8_77_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2003.11.136"},{"key":"e_1_2_8_78_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11912\u2010022\u201001302\u20103"},{"key":"e_1_2_8_79_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.coph.2018.02.006"},{"key":"e_1_2_8_80_1","doi-asserted-by":"publisher","DOI":"10.1080\/17476348.2021.1964362"},{"key":"e_1_2_8_81_1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers17203298"},{"key":"e_1_2_8_82_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms26189244"},{"key":"e_1_2_8_83_1","doi-asserted-by":"publisher","DOI":"10.4081\/monaldi.2022.2440"},{"key":"e_1_2_8_84_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annonc.2020.09.009"},{"key":"e_1_2_8_85_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470\u20102045(21)00471\u2010X"},{"key":"e_1_2_8_86_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470\u20102045(18)30765\u20104"},{"key":"e_1_2_8_87_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(20)32714\u20108"},{"key":"e_1_2_8_88_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annonc.2022.08.077"},{"key":"e_1_2_8_89_1","doi-asserted-by":"publisher","DOI":"10.1158\/1078\u20100432.CCR\u201021\u20101466"},{"key":"e_1_2_8_90_1","doi-asserted-by":"publisher","DOI":"10.1158\/1078\u20100432.CCR\u201019\u20100103"},{"key":"e_1_2_8_91_1","doi-asserted-by":"publisher","DOI":"10.1159\/000543414"},{"key":"e_1_2_8_92_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(23)01613\u20106"},{"key":"e_1_2_8_93_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12672\u2010025\u201004200\u20109"},{"key":"e_1_2_8_94_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10147\u2010025\u201002706\u20104"},{"key":"e_1_2_8_95_1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers14246063"},{"key":"e_1_2_8_96_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.esmoop.2024.104123"},{"key":"e_1_2_8_97_1","doi-asserted-by":"publisher","DOI":"10.1186\/1756\u20100500\u20105\u2010482"},{"key":"e_1_2_8_98_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.lungcan.2007.08.031"},{"key":"e_1_2_8_99_1","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdi187"},{"key":"e_1_2_8_100_1","doi-asserted-by":"publisher","DOI":"10.1038\/bjc.1996.634"},{"key":"e_1_2_8_101_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12885\u2010022\u201009490\u20108"},{"key":"e_1_2_8_102_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms251910861"},{"key":"e_1_2_8_103_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41379\u2010019\u20100364\u2010z"},{"key":"e_1_2_8_104_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41591\u2010023\u201002593\u20100"},{"key":"e_1_2_8_105_1","doi-asserted-by":"publisher","DOI":"10.1080\/2162402X.2016.1261241"},{"key":"e_1_2_8_106_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0307204"}],"container-title":["Thoracic Cancer"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1759-7714.70259","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/1759-7714.70259","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1759-7714.70259","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T09:57:25Z","timestamp":1777370245000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/1759-7714.70259"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4]]},"references-count":105,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2026,4]]}},"alternative-id":["10.1111\/1759-7714.70259"],"URL":"https:\/\/doi.org\/10.1111\/1759-7714.70259","archive":["Portico"],"relation":{},"ISSN":["1759-7706","1759-7714"],"issn-type":[{"value":"1759-7706","type":"print"},{"value":"1759-7714","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4]]},"assertion":[{"value":"2025-10-19","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-02-27","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-23","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70259"}}