胸膜间皮瘤是一种起源于胸膜的罕见且侵袭性的癌症，具有毁灭性的预后和有限的治疗选择。近年来，这种疾病的治疗取得了重大进展。自2021年以来，纳武单抗和易普利姆玛免疫检查点抑制剂已成为胸膜间皮瘤一线治疗的新标准。虽然化疗和免疫检查点抑制剂的组合似乎是下一步，但由于我们对以下方面的了解，靶向治疗正在出现：胸膜间皮瘤的肿瘤发生。此外，目前正在研究几种新策略，包括病毒疗法、抗体药物偶联物，甚至是 CAR-T 细胞或树突状细胞的细胞疗法。在这篇综述中，我们将根据已进行的临床试验，探索可能改变患者生活的各种未来机会。未来的临床研究旨在在疾病进展后对患者进行重新活检，以确定新的分子改变并与辅助治疗相关。研究，指导后续的治疗决策。预测和研究治疗耐药机制将带来创新方法和改善治疗结果。

Pleural mesothelioma is a rare and aggressive cancer originating in the pleura, with a devastating prognosis and limited treatment options. There have been significant advancements in the management of this disease in recent years. Since 2021, nivolumab and ipilimumab immune checkpoint inhibitors have become the new standard of care for first-line treatment of pleural mesothelioma.While a combination of chemotherapy and immune checkpoint inhibitors appears to be the next step, targeted therapies are emerging thanks to our understanding of the oncogenesis of pleural mesothelioma. Moreover, several new strategies are currently being investigated, including viral therapy, antibody-drug conjugates, and even cell therapies with CAR-T cells or dendritic cells. In this review, we will explore the various future opportunities that could potentially transform patients' lives in light of the clinical trials that have been conducted.Future clinical studies aim to rebiopsy patients after disease progression to identify new molecular alterations and to be associated with ancillary studies, guiding subsequent therapy decisions. Predicting and investigating treatment resistance mechanisms will lead to innovative approaches and improved treatment outcomes.