Epidemiology of Malignant Mesothelioma
Peak Asbestos Consumption in Australia in 1975 (90% in asbestos cement industry)
First documented MPM case in Australia in 1947
The incidence of mesothelioma is expected to increase and peak between 2015 and 2020
The median latency period from first exposure to clinical manifestation is around 40 years
Genetic predisposition for MPM is likely

Mesothelin is a cell surface glycoprotein, expressed on normal mesothelial cells and > 90% of mesotheliomas (binds to CA125)
Soluble mesothelin-related proteins in serum
Cell surface glycoprotein, binding to integrin and CD 44 receptors
Elevated serum levels of Osteopontin in MPM compared with controls Pass et al, NEJM 2005
Immunohistochemistry +
Osteopontin expression in other tumours

Chemotherapy Spectrum
Anthracyclines (Doxorubicin)
Taxanes (Paclitaxel)
Vinca Alkaloids (Vinorelbine)
Antimetabolites: Edatrexate, Gemcitabine, Pemetrexed & Raltitrexed
Combinations: Cisplatin, Carboplatin

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