Mesothelin-Targeted Agents in Mesothelioma

Mesothelin (MSLN) is a cell surface glycoprotein expressed by mesothelial cells of the pleural, peritoneum, and pericardium. Its function in promoting tumor growth and its overexpression in malignant mesothelioma make this protein as a promising target for treatment of affected patients. Several treatment strategies have been explored in latest years. SS1P immunotoxin has the main limitation of early serum neutralizing antibodies production, thus leading to immunotoxin combinations and new-generation immunotoxins currently under investigation. Among mesothelin-targeted antibodies, both monoclonal antibodies such as amatuximab and antibody–drug conjugates such as anetumab–ravtansine are currently under investigation in combination with the standard of care platinum-based doublet plus pemetrexed chemotherapy. Anti-mesothelin vaccines and intrapleural administration of CAR-T meso therapies represent promising future strategies for malignant pleural mesothelioma patients even though these deserve further investigation.