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The increasing number of malignant pleural mesothelioma (MPM) is a serious public health problem. The prognosis of this tumor is poor and most of the patients are diagnosed late in the disease's course when curative treatment is no more an option. It is therefore necessary to diagnose earlier MPM in these patients in order to obtain a potential significant improvement in survival. Some serum markers have been previously proposed for MPM diagnosis but none had sufficient sensitivity and specificity for being use in routine. Recently, soluble mesothelin and osteopontin have been proposed as diagnostic markers for mesothelioma. The authors reviewed recent data concerning the utility of these two molecules in the diagnosis and the treatment of MPM. Mesothelin seems to be a specific marker for the epithelioid subtype of mesothelioma. Despite a good sensitivity, osteopontin has a low specificity for mesothelioma diagnosis. However, there is not enough data yet to propose guidelines on the use of these markers in a day to day practice.

Malignant pleural mesothelioma (MPM) is a rare malignancy of the pleura with a very poor prognosis. Treatments evaluated for malignant mesothelioma, including chemotherapy, radiotherapy and surgery are of limited efficacy. Given that some patients with MPM bear tumours regressing spontaneously or responding to immunotherapy suggests that the immune system may respond to MPM under some circumstances. Animal studies have also demonstrated immunoreactivity to MPM to different immunotherapies. Clinical trials investigating new trends in the treatment of stage I and II malignant mesothelioma have shown both immunotherapy and systemic chemo-immunotherapy to be efficacious. In addition, recent progresses in early detection techniques also provide hope that patients can be treated efficiently, at an earlier stage and well monitored. Thus, immunotherapy of cancer is undoubtedly a highly promising but also very challenging approach in the treatment of a disease that has slipped through the defence lines of the immune system. This article will review past and recent developments of such a clinical strategy.