**1. Introduction**

Malignant pleural mesothelioma (MPM) is a primary malignancy of the pleura. The main aetiological agent is asbestos. The latency period lasts several decades, and in countries where its use was banned in the 1950's and 1960's, the incidence is expected to peak within the coming decade. However, in the many other countries it continues to be mined and used. The incidence in these countries can be expected to continue to rise.

The prognosis for MPM is dismal and the median survival from the time of diagnosis is 12 to 18 months. Current therapies are blunt weapons that are very morbid but at the same time ineffective. They have barely made an impact on the poor outcomes of mesothelioma.

In this chapter, we will review the current knowledge on mesothelioma pathogenesis, epidemiology, biology and treatment. We will focus on nonoperative therapies and the role of surgery will be covered in another chapter.
