Development of a Novel Prognostic Risk Classification System for Malignant Pleural Mesothelioma

The use of a next-generation sequencing-derived machine-learning risk-prediction model (OncoCast-MPM) for malignant pleural mesothelioma: a retrospective study

“…22 In modern analyses, many of these factors have been reconfirmed 6,23,24 and other factors have been identified. [25][26][27][28][29][30][31] Unfortunately, the existing indices are unable to integrate clinical characteristics, pathological features, and molecular profiling, and are also unable to generate patientlevel prognostication.…”

The Prognostic Value of 18F-FDG PET Imaging at Staging in Patients with Malignant Pleural Mesothelioma: A Literature Review

“…Analyzing the full-text version of the remaining 31 studies, there were 12 excluded (4 articles including patients with MPM recurrence); 3 articles from the same referring center; 3 articles including MPM patients with both baseline (pre-treatment) and post-treatment PET, but not reporting prognostic analysis of baseline PET data; 1study with a prognostic analysis performed only in a subgroup population; and 1 article including patients with both peritoneal and pleural mesothelioma, with no separate information on MPM subgroup). Finally, 19 studies were included and analyzed in this review [ 29 , 32 , 33 , 34 , 35 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 ].…”

“…In this context, selected patients with a homogeneous clinical staging were exclusively analyzed only in three papers [ 29 , 45 , 50 ]. Regarding clinical indications of PET exams, in all the included studies, 18 F-FDG PET imaging was performed for staging purpose (i.e., in MPM patients at first diagnosis) according to the research topic and inclusion criteria of our review: in 17/19 studies, 18 F-FDG PET imaging was exclusively performed at baseline (before any therapy) [ 32 , 33 , 34 , 35 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 47 , 48 , 49 , 50 ]; in the remaining 2/19 studies [ 29 , 46 ], a second PET scan after systemic therapy was performed for treatment response assessment. Information on talc pleurodesis performed before PET scans was available in 13/19 studies; almost half of these studies (6/13) included a cohort of patients submitted to previous talc pleurodesis, ranging from 30% to 50% [ 29 , 32 , 34 , 41 , 44 , 46 ].…”

Preoperative Identification of Benefit from Surgery for Malignant Pleural Mesothelioma

“…The group with the worst survival (0% alive, median survival 7.5 months, termed risk group 4d) had weight loss, a PS of 0 or 1, and sarcomatoid histologic characteristics. 110 A Japanese group led by Doi 111 developed a new Novel Prognostic Risk Classification System. 111 Pathologic subtype, serum LDH, NLR ratio, and total lesion glycolysis (TLG) in 18 F-FDG PET/CT were independent and significant prognostic factors.…”

“…110 A Japanese group led by Doi 111 developed a new Novel Prognostic Risk Classification System. 111 Pathologic subtype, serum LDH, NLR ratio, and total lesion glycolysis (TLG) in 18 F-FDG PET/CT were independent and significant prognostic factors. Univariate and multivariate analyses revealed that the significant independent predictors of poor survival outcomes were the nonepithelioid histologic type, increased serum LDH, an NLR of !5.0, and a TLG of !525 g. 111 The problem with most of the scores so far is the lack of validation in independent cohorts and the inclusion of clinical variables being available before surgery to help decision-making for or against surgical resection.…”