Abstract:
Malignant mesotheliomas (MM) are hard to treat malignancies with poor prognosis and
high mortality rates. This cancer is highly misdiagnosed in Sub-Saharan African countries. According
to literature, the incidence of MM is likely to increase particularly in low-middle-income countries
(LMICs). The burden of asbestos-induced diseases was estimated to be about 231,000 per annum.
Lack of awareness and implementation of regulatory frameworks to control exposure to asbestos
fibers contributes to the expected increase. Exposure to asbestos fibers can lead to cancer initiation by
several mechanisms. Asbestos-induced epigenetic modifications of gene expression machinery and
non-coding RNAs promote cancer initiation and progression. Furthermore, microbiome–epigenetic
interactions control the innate and adaptive immunity causing exacerbation of cancer progression and
therapeutic resistance. This review discusses epigenetic mechanisms with more focus on miRNAs
and their interaction with the microbiome. The potential use of epigenetic alterations and microbiota
as specific biomarkers to aid in the early detection and/or development of therapeutic targets is
explored. The advancement of combinatorial therapies to prolong overall patient survival or possible
eradication of MM especially if it is detected early is discussed.
