• A Scherpereel, M-C Willemin, E Wasielewski, and X Dhalluin.
• Pneumologie et oncologie thoracique, université Lille, Inserm U1019, CHU de Lille, CIIL, Institut Pasteur, 59000 Lille, France; MESOCLIN-réseau national des centres cliniques experts pour la prise en charge des mésothéliomes pleuraux malins, domiciliation du centre coordinateur national, CHU de Lille, 59000 Lille, France. Electronic address: arnaud.scherpereel@chru-lille.fr.
• Rev Mal Respir. 2018 Apr 1; 35 (4): 465-476.

IntroductionMalignant pleural mesothelioma (MPM) is a quite rare cancer, but with increasing incidence, that is usually induced by previous asbestos exposure. Its prognosis is poor and there is no validated curative therapy to date. Surgery of MPM, done only by few expert teams within a multimodal treatment is of limited and still disputed value. The standard treatment of MPM, relying on first-line chemotherapy by combined cisplatin-pemetrexed is often poorly effective, even if combination with bevacizumab anti-VEGF antibodies has slightly improved the results. Moreover, no second line treatment is recommended in case of failure of this chemotherapy. Therefore, the search of new therapies or strategies is crucial and the recruitment of patients in clinical trials is highly encouraged.BackgroundAmong the treatments under investigation, various anti-tumour immunotherapies, in particular immune checkpoints inhibitors (ICI), currently exhibit the most promising preliminary results. First data from the phase II, randomized "IFCT MAPS-2", recently presented during the 2017 ASCO meeting, confirmed the value of ICI in MPM patients in cases of chemotherapy failure.Outlook And ConclusionsHowever, several exciting immunotherapies other than ICI are presently being evaluated in MPM and are reported in this article. Moreover, many questions still need to be answered about immunotherapy: what is its potential value as first line treatment? How to target the best candidates for these treatments? Which combinations between immunotherapy and standard chemotherapy, targeted therapies, surgery or radiotherapy? Finally, it is now essential that every clinician has sufficient knowledge about the possible toxicities of immunotherapy.Copyright © 2017 SPLF. Published by Elsevier Masson SAS. All rights reserved.

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