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Malignant pleural mesothelioma is an aggressive type of cancer in which cancerous cells are found in the lining of the abdomen or chest that occurs due to asbestos exposure in the mesothelium. According to the National Cancer Institute's Surveillance, Epidemiology and End Results (SEER), there are around 2,500-3,000 new cases per year of malignant mesothelioma observed in the United States, mainly in elderly men. It occurs mainly in males as compared to females and the chances of risk increases with the age, but this cancer can emerge in both males and females at any age. It forms due to the neoplastic transformation of mesothelial cells and it is associated with the genetic changes and other phenotypic changes, which change cell-matrix and cell-cell interaction and regulation of cell death and cell proliferation. The targeted treatment is focused at a precise molecular target, which is very close to a hallmark of cancer. These targets should be assessable with a specific biomarkers and the measurement of these targets should be associated with different clinical outcome when these targeted treatment is administered. Malignant pleural mesothelioma is characterized via a composite genomic modification, through the defeat of chromosomal loci encoding for different tumor suppressor genes such as TP53, NF2, p14, and p16. These types of genomic changes are very ordinary but, unluckily, these are not appropriate to be targeted through the available drugs. Over the last decade, various targeted agents have been explored in malignant pleural mesothelioma, and in some of them; the preclinical rationale was very weak for exploring clinical activity. There are some drugs which consistently revealed their activity in malignant pleural mesothelioma, but these drugs are under clinical trials.

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