Treatment of Pleural Mesothelioma: ASCO Guideline Update

J Clin Oncol. 2025 Mar 10;43(8):1006-1038. doi: 10.1200/JCO-24-02425. Epub 2025 Jan 8.

Abstract

Purpose: To provide evidence-based recommendations to practicing physicians and others on the management of pleural mesothelioma (PM).

Methods: ASCO convened an Expert Panel of medical oncology, thoracic surgery, radiation oncology, pathology, cancer genetics, and advocacy experts to conduct an updated literature search, which included systematic reviews, meta-analyses, randomized controlled trials, and prospective and retrospective comparative observational studies published from 2016 through 2024. Outcomes of interest included survival, disease-free or recurrence-free survival, and quality of life. Expert Panel members used available evidence and informal consensus to develop evidence-based guideline recommendations.

Results: The literature search identified 110 additional relevant studies to inform the evidence base for this guideline.

Recommendations: Evidence-based recommendations were developed for surgical cytoreduction, immunotherapy, chemotherapy, pathology, and germline testing in patients with PM.Additional information is available at www.asco.org/thoracic-cancer-guidelines.

Publication types

  • Practice Guideline

MeSH terms

  • Humans
  • Lung Neoplasms* / pathology
  • Lung Neoplasms* / therapy
  • Mesothelioma* / diagnosis
  • Mesothelioma* / genetics
  • Mesothelioma* / pathology
  • Mesothelioma* / therapy
  • Mesothelioma, Malignant
  • Pleural Neoplasms* / diagnosis
  • Pleural Neoplasms* / genetics
  • Pleural Neoplasms* / pathology
  • Pleural Neoplasms* / therapy