Efficacy of chemotherapy for malignant pleural mesothelioma according to histology in a real-world cohort

Cedrés, S.; Assaf, J.D.; Iranzo, Patricia Izquierdo; Callejo, Ana; Pardo, Núria; Navarro, Alejandro; Martinez-Martí, Alex; Marmolejo, David; Rezqallah, Alejandra; Carbonell, Caterina; Frigola, Joan; Amat, Ramon; Pedrola, A.; Dienstmann, Rodrigo; Felip, Enriqueta

doi:10.1038/s41598-021-00831-4

Cited by 10 publications

(6 citation statements)

References 28 publications

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“…Previous studies have reported that the histological type is an important factor affecting the survival time, and the prognosis of MMe patients with epithelial histological type is better than the non-epithelial type (43)(44)(45)(46)(47). Similarly, our study also found that the survival outcomes of MMe patients were closely related to their tissue type.…”

Section: Discussionsupporting

confidence: 83%

Survival analysis and development of a prognostic nomogram for patients with malignant mesothelioma in different anatomic sites

et al. 2022

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BackgroundMalignant mesothelioma (MMe) is a rare and fatal cancer with a poor prognosis. Our study aimed to compare the overall survival (OS) of MMe patients across various sites and develop a prognostic model to provide a foundation for individualized management of MMe patients.MethodsFrom the Surveillance, Epidemiology, and End Results (SEER) database, 1,772 individuals with malignant mesothelioma (MMe) were identified. The X-tile software was used to identify the optimal cut-off point for continuous variables. The Kaplan–Meier method was employed to compare the survival of MMe across different sites. The Cox proportional hazards model was applied to identify the independent risk factors of overall survival (OS) and a nomogram was constructed.ResultsIn the survival analysis, MMe originating from the reproductive organs and hollow organs showed a relatively better prognosis than those originating from soft tissue, solid organs, and pleura. Age, gender, location, histological type, grade of differentiation, extent of disease, lymph node status, lymph node ratio (LNR), and chemotherapy were all found to be independent risk variables for the prognosis of MMe patients (P<0.05) in a multivariate Cox analysis and were included in the construction of nomogram. In the training and testing sets, the C-index of the nomogram was 0.701 and 0.665, respectively, and the area under the ROC curve (AUROC) of the 1-, 3-, and 5-year overall survival rate was 0.749, 0.797, 0.833 and 0.730, 0.800, 0.832, respectively. The calibration curve shows that the nomogram is well-calibrated.ConclusionsThis is the first research to examine the prognosis of MMe patients based on the location. However, previous studies often focused on malignant pleural mesothelioma or malignant peritoneal mesothelioma with high incidence. Furthermore, a nomograph with good prediction efficiency was established according to the variables that influence patient survival outcomes, which provides us with a reference for clinical decision-making.

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Section: Discussionsupporting

confidence: 83%

Survival analysis and development of a prognostic nomogram for patients with malignant mesothelioma in different anatomic sites

et al. 2022

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“…Cedres et al evaluated, in a retrospective cohort of 189 patients, systemic therapy outcomes according to histology (26). The study was focused on chemotherapy, confirming better results in terms of OS and PFS in epithelioid than in non-epithelioid tumors in first line setting (26.7 vs 15.0 months for OS, p<0.001, respectively; 4.8 vs 3.6 months for PFS, p=0.03, respectively).…”

Section: Histologymentioning

confidence: 92%

“…• Data about response according to histology are mostly not reported or too small to draw definitive conclusions (6,8,11,13,18,19,26).…”

Section: Histologymentioning

confidence: 99%

Immunotherapy with immune checkpoint inhibitors and predictive biomarkers in malignant mesothelioma: Work still in progress

et al. 2023

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Malignant mesothelioma (MM) is a rare and aggressive neoplasm, usually associated with a poor prognosis (5 years survival rate <10%). For unresectable disease, platinum and pemetrexed chemotherapy has been the only standard of care in first line for more than two decades, while no standard treatments have been approved in subsequent lines. Recently, immunotherapy has revolutionized the therapeutic landscape of MM. In fact, the combination of ipilimumab plus nivolumab has been approved in first line setting. Moreover, immune checkpoint inhibitors (ICIs) showed promising results also in second-third line setting after platinum-based chemotherapy. Unfortunately, approximately 20% of patients are primary refractory to ICIs and there is an urgent need for reliable biomarkers to improve patient’s selection. Several biological and molecular features have been studied for this goal. In particular, histological subtype (recognized as prognostic factor for MM and predictive factor for chemotherapy response), programmed death ligand 1 (PD-L1) expression, and tumor mutational burden (widely hypothesized as predictive biomarkers for ICIs in several solid tumors) have been evaluated, but with unconclusive results. On the other hand, the deep analysis of tumor infiltrating microenvironment and the improvement in genomic profiling techniques has led to a better knowledge of several mechanisms underlying the MM biology and a greater or poorer immune activation. Consequentially, several potential biomarkers predictive of response to immunotherapy in patients with MM have been identified, also if all these elements need to be further investigated and prospectively validated.In this paper, the main evidences about clinical efficacy of ICIs in MM and the literature data about the most promising predictive biomarkers to immunotherapy are reviewed.

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“…MPM has an extremely short survival rate, about 8 to 14 months following diagnosis ( 83 ). Histological subtype in MPM has been widely recognized as a prognostic factor, with non-epithelioid histology considered as a predictor of poor survival in two main prognostic scores [European Organization for Research and Treatment of Cancer (EORTC); Cancer and Leukemia Group B (CALGB)] ( 73 ). Furthermore, biphasic forms of non-epithelioid mesothelioma can exhibit a variable percentage of epithelioid differentiation.…”

Section: Differences Between Ar-mpm and Non-ar-mpmmentioning

confidence: 99%

The genetic susceptibility in the development of malignant pleural mesothelioma: somatic and germline variants, clinicopathological features and implication in practical medical/surgical care: a narrative review

Congedo,

West,

Evangelista

et al. 2024

J Thorac Dis

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Background and Objective Malignant pleural mesothelioma (MPM) is a very aggressive primary tumor of the pleura whose main risk factor is exposure to asbestos. However, only a minority of exposed people develops MPM and the incidence of MPM cases without an apparent association with asbestos exposure has been increasing in recent years, suggesting that genetic predisposing factors may play a crucial role. In addition, several studies reported familial cases of MPM, suggesting that heredity may be an important and underestimated feature in MPM development. Several candidate genes have been associated with a predisposition to MPM and most of them play a role in DNA repair mechanisms: overall, approximately 20% of MPM cases may be related to genetic predisposition. A particular category of patients with high susceptibility to MPM is represented by carriers of pathogenic variants in the BAP1 gene. Germline variants in BAP1 predispose to the development of MPM following an autosomal dominant pattern of inheritance in the familial cases. MPMs in these patients are significantly less aggressive, and patients require a multidisciplinary approach that involves genetic counseling, medical genetics, pathology, surgical, medical, and radiation oncology expertise. In the present narrative review, we presented a comprehensive overview of genetic susceptibility in the development of MPM. Methods The narrative review is based on a selective literature carried out in PubMed in 2023. Inclusion criteria were original articles in English language, and clinical trials (randomized, prospective, or retrospective). Key Content and Findings We summarized the somatic and germline variants and the differences in terms of clinicopathological features and prognosis between gene-related MPM (GR-MPM) and asbestos-related MPM (AR-MPM). We also discussed the indications for screening, genetic testing, and surveillance of patients with BAP1 germline variants. Conclusions In this narrative review, we have emphasized that the BAP1 gene’s harmful germline variations are inherited in an autosomal dominant manner in familial cases. MPMs in individuals with these variations are less severe, and their medical care necessitates a collaborative effort. Additionally, we have outlined the current therapeutic prospects for MPM, including the possibility of gene-specific therapy, which is currently promising but still requires clinical validation.

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Efficacy of chemotherapy for malignant pleural mesothelioma according to histology in a real-world cohort

Cited by 10 publications

References 28 publications

Survival analysis and development of a prognostic nomogram for patients with malignant mesothelioma in different anatomic sites

Survival analysis and development of a prognostic nomogram for patients with malignant mesothelioma in different anatomic sites

Immunotherapy with immune checkpoint inhibitors and predictive biomarkers in malignant mesothelioma: Work still in progress

The genetic susceptibility in the development of malignant pleural mesothelioma: somatic and germline variants, clinicopathological features and implication in practical medical/surgical care: a narrative review

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