Mechanisms of Chemoresistance in Malignant Pleural Mesothelioma: The Regulatory Role of miRNAs

Malignant pleural mesothelioma (MPM), is a rare and aggressive cancer that originates in the mesothelium lining the lungs. It is considered an occupational disease associated with exposure to asbestos in the workplace. MPM is often diagnosed in the late stages and has a poor response to treatment. Since the cause of the limited response to therapy in patients with MPM is unknown, it is necessary to establish the mechanisms related to chemoresistance, such as microRNAs (miRNAs), which play a specific role. Several studies have demonstrated that the downregulation of miR-15 and miR-16 in MPM cell lines is associated with chemoresistance, and that their overexpression contributes to sensitizing cells to chemotherapy. In addition, some miRNAs have been shown to be associated with epithelial-mesenchymal transition (EMT) in MPM cells. EMT has been linked to the acquisition of a chemoresistant phenotype; moreover, the release of miRNAs into circulating exosomes from patients with MPM could also impact the resistance to conventional treatments. This review aims to summarize the current knowledge on the role of miRNAs in MPM and their relationship with chemoresistance, as well as to establish new knowledge to support the development of improved treatment for patients with MPM.