**4. Conclusions**

In conclusion, the optimal treatment of MPM is still a matter of debate. Surgery, CT, and RT have failed as single modality therapies with no effects on patients' survival. It is evident that optimal multidisciplinary care is fundamental in the management of MPM patients, as the best results are obtained when patients manage to undergo more complex treatment protocols, often consisting in trimodality approaches. New prospective studies are needed to provide high-quality evidence on the field. While it is reasonable to assume that surgery will remain a central component in the multimodality treatment of MPM, a great development is expected from novel treatment modalities such as targeted therapies, T-cell therapy, vaccines and other investigational therapies, leading to the possibility of prolonged control of the disease, increased survival rates, and better quality of life.
