Invariably mesothelioma is diagnosed late in the development of the di
sease when treatment is no longer effective. Therefore, a key to reduc
ing the mortality rate of this neoplasm is knowledge of the general se
quence of genetic events between initiation of mesothelial cells and t
he emergence of the metastatic tumor cells. Unfortunately, relatively
little is known about the early changes in the genesis of this disease
. Of the known changes, the most frequent are in the tumor-suppressor
genes p16(INK4a) and NF2 and possibly that SV40 virus large T-antigen
oncogene. The molecular nature of the changes in these genes as well a
s other alterations are addressed in this overview.