Mesothelioma
Asbestos and the long latency, telling mesothelioma from benign asbestos disease, thoracoscopic biopsy and the BAP1 and MTAP stains, histology and prognosis, nivolumab-ipilimumab or chemo-immunotherapy first line, why radical surgery has fallen away, and notification and compensation in Australia.
Tier 2Condition
Written with AI assistance and fact-checked against the sources below. For exam study, not clinical decisions. How notes are made
At a glance
- A cancer of the mesothelium, about 90% pleural, most of the rest peritoneal. WHO 2021 dropped the word "malignant": it's now "pleural mesothelioma".
- Over 80% follow asbestos exposure. Australia has one of the highest rates in the world, with roughly 700 to 800 new cases a year, because of crocidolite mining at Wittenoom and heavy use of asbestos building products until the 2003 ban.
- Latency 20 to 50 years. The newer "third wave" comes from home renovation and other non-occupational exposure.
Loading the rest of the note…
Finished reading?
Sources
- Mesothelioma in Australia 2025 (Australian Mesothelioma Registry)AU/NZAustralian Institute of Health and Welfare, 2026
- eviQ Cancer Treatments Online (mesothelioma protocols)AU/NZCancer Institute NSW
- Kindler HL et al. Treatment of pleural mesothelioma: ASCO guideline update. J Clin Oncol 2025;43American Society of Clinical Oncology, 2025
- Mesothelioma: Pleural, Version 3.2026. NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw 2026National Comprehensive Cancer Network, 2026
- Popat S et al. Malignant pleural mesothelioma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 2022;33:129-42European Society for Medical Oncology, 2022 (latest ESMO version, November 2026)
- Husain AN et al. Guidelines for pathologic diagnosis of mesothelioma: 2023 update of the consensus statement. Arch Pathol Lab Med 2024International Mesothelioma Interest Group, 2024
- Baas P et al. First-line nivolumab plus ipilimumab in unresectable malignant pleural mesothelioma (CheckMate 743). Lancet 2021;397:375-86The Lancet, 2021
- Chu Q et al. Pembrolizumab plus chemotherapy versus chemotherapy in untreated advanced pleural mesothelioma (IND.227/KEYNOTE-483). Lancet 2023;402:2295-306The Lancet, 2023
- Lim E et al. Extended pleurectomy decortication and chemotherapy versus chemotherapy alone for pleural mesothelioma (MARS 2). Lancet Respir Med 2024;12:457-66The Lancet Respiratory Medicine, 2024
- Last updated
- 14 November 2026
What changed
- 14 November 2026 Personal emails, About story and Australian-style copy