这篇综述深入探讨了胸膜间皮瘤 (PM) 的复杂情况，强调了细致入微的治疗策略的必要性。虽然铂类化疗仍然是基石，但免疫检查点抑制剂 (ICIs) 的出现，特别是通过 Checkmate 743 试验，重塑了治疗范式。由于患者的异质性和缺乏特定的生物标志物，挑战仍然存在。针对基因型和表型改变成为一种有前途的途径，需要对这种罕见疾病进行精确的肿瘤学治疗。 PM 中普遍存在的 CDKN2A 缺失可能对 CDK4/6 抑制剂有反应。 MMR 和 HR 的缺陷建议分别使用 ICI 或 PARP 抑制剂进行定制治疗。正在进行的试验探索新型抑制剂和有前途的靶点，如 MSLN。实施这些策略需要克服患者选择、联合疗法、生物标志物识别和成本考虑方面的挑战。合作对于将这些见解转化为有影响力的临床干预措施至关重要，预示着 PM 的个性化和精准医疗时代的到来。版权所有 © 2024。由 Elsevier B.V. 出版。

This review delves into the intricate landscape of pleural mesothelioma (PM), emphasizing the need for nuanced therapeutic strategies. While platinum-based chemotherapy remains a cornerstone, the advent of immune checkpoint inhibitors (ICIs), notably through the Checkmate 743 trial, has reshaped treatment paradigms. Challenges persist due to patient heterogeneity and a lack of specific biomarkers. Targeting genotypic and phenotypic alterations emerges as a promising avenue, demanding precision oncology in this rare disease. CDKN2A loss, prevalent in PM, may respond to CDK4/6 inhibitors. Defects in MMR and HR suggest tailored approaches with ICI or PARP inhibitors, respectively. Ongoing trials explore novel inhibitors and promising targets like MSLN. Implementing these strategies requires overcoming challenges in patient selection, combination therapies, biomarker identification, and cost considerations. Collaboration is crucial for transforming these insights into impactful clinical interventions, heralding the era of personalized and precision medicine for PM.Copyright © 2024. Published by Elsevier B.V.