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Review

Molecular Insights into Pleural Mesothelioma: Unveiling Pathogenic Mechanisms and Therapeutic Opportunities

by
Teodora Zahiu
1,†,
Carmen Mihaela Mihu
2,*,†,
Bianca A. Bosca
2,
Mariana Mărginean
2,
Lavinia Patricia Mocan
2,
Roxana-Adelina Ștefan
2,
Rada Teodora Suflețel
2,
Carina Mihu
3 and
Carmen Stanca Melincovici
2,†
1
Radiology and Imaging Department, County Emergency Hospital, 400006 Cluj-Napoca, Romania
2
Department of Morpho-Functional Sciences, Discipline of Histology, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
3
NovoGyn, Dostoievski 16, 400000 Cluj-Napoca, Romania
*
Author to whom correspondence should be addressed.
These authors contributed equally to this work.
Diagnostics 2025, 15(11), 1323; https://doi.org/10.3390/diagnostics15111323 (registering DOI)
Submission received: 29 March 2025 / Revised: 16 May 2025 / Accepted: 20 May 2025 / Published: 24 May 2025
(This article belongs to the Section Pathology and Molecular Diagnostics)

Abstract

Pleural mesothelioma (PM) is a rare disease, which is going to be a global medical concern in the 21st century, because of its aggressiveness, late diagnosis, and insufficient therapies. This review seeks to enhance the comprehension of medical professionals regarding the risk factors and environmental influences that contribute to the development of the disease, as well as its underlying mechanisms. In addition, we aim to provide a schematic yet thorough overview of diagnostic techniques in PM, emphasizing the significance of the immunohistochemical markers BAP1 and MTAP, with the latter serving as an almost ideal surrogate for the gold-standard diagnostic approach, FISH p16/CDKN2A deletion. The scientific world is grappling with BAP1, MTAP, and the tumour inflammatory microenvironment, because they are the key for personalized treatments and palliative care in this disease. Considering that the survival rate for patients with PM seldom surpasses five years, every moment is significant. Therefore, our article also highlights recent advancements in clinical assessments related to prognostic scoring and treatment options. PM is a complex disease, with gradual progression over decades, which requires further investigation covering the prevention, mutations, diagnosis and treatment.
Keywords: BAP1; MTAP; asbestos; pleural mesothelioma; immunohistochemical markers; immunohistochemistry; inflammatory microenvironment; diagnosis; prognosis BAP1; MTAP; asbestos; pleural mesothelioma; immunohistochemical markers; immunohistochemistry; inflammatory microenvironment; diagnosis; prognosis

Share and Cite

MDPI and ACS Style

Zahiu, T.; Mihu, C.M.; Bosca, B.A.; Mărginean, M.; Mocan, L.P.; Ștefan, R.-A.; Suflețel, R.T.; Mihu, C.; Melincovici, C.S. Molecular Insights into Pleural Mesothelioma: Unveiling Pathogenic Mechanisms and Therapeutic Opportunities. Diagnostics 2025, 15, 1323. https://doi.org/10.3390/diagnostics15111323

AMA Style

Zahiu T, Mihu CM, Bosca BA, Mărginean M, Mocan LP, Ștefan R-A, Suflețel RT, Mihu C, Melincovici CS. Molecular Insights into Pleural Mesothelioma: Unveiling Pathogenic Mechanisms and Therapeutic Opportunities. Diagnostics. 2025; 15(11):1323. https://doi.org/10.3390/diagnostics15111323

Chicago/Turabian Style

Zahiu, Teodora, Carmen Mihaela Mihu, Bianca A. Bosca, Mariana Mărginean, Lavinia Patricia Mocan, Roxana-Adelina Ștefan, Rada Teodora Suflețel, Carina Mihu, and Carmen Stanca Melincovici. 2025. "Molecular Insights into Pleural Mesothelioma: Unveiling Pathogenic Mechanisms and Therapeutic Opportunities" Diagnostics 15, no. 11: 1323. https://doi.org/10.3390/diagnostics15111323

APA Style

Zahiu, T., Mihu, C. M., Bosca, B. A., Mărginean, M., Mocan, L. P., Ștefan, R.-A., Suflețel, R. T., Mihu, C., & Melincovici, C. S. (2025). Molecular Insights into Pleural Mesothelioma: Unveiling Pathogenic Mechanisms and Therapeutic Opportunities. Diagnostics, 15(11), 1323. https://doi.org/10.3390/diagnostics15111323

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