Factors affecting the life expectancy in malignant pleural mesothelioma: Our 10 years of studies and experience

Çimen, Filiz; Agackiran, Yetkin; Düzgün, Sevim; Aloğlu, Melike; Şentürk, Ayşegül; Atikcan, Şükran

doi:10.1097/md.0000000000030711

Cited by 4 publications

(2 citation statements)

References 29 publications

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“…Our multivariate analysis showed that the prognosis of elderly patients with mesothelioma was worse than that of young patients. This was consistent with the results of many previous studies [ 35 , 47 ], which was easy to understand. Elderly patients generally had more basic diseases, poor pulmonary function, and limited access to treatment.…”

Section: Discussionsupporting

confidence: 93%

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Predicting survival for patients with mesothelioma: development of the PLACE prognostic model

Zhang¹,

Li²,

Li³

et al. 2023

BMC Cancer

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Introduction The overall survival of patients with mesothelioma is poor and heterogeneous. At present, the prediction model for Chinese patients needs to be improved. We sought to investigate predictors of survival in malignant pleural mesothelioma and develop prognostic prediction models. Methods This Two-center retrospective cohort study recruited patients with pathologically diagnosed mesothelioma at Beijing Chao-Yang Hospital and Beijing Tong-Ren Hospital. We developed a new prognostic prediction model based on COX multivariable analysis using data from patients who were recruited from June 1, 2010 to July 1, 2021 in Beijing Chao-Yang Hospital (n = 95, development cohort) and validated this model using data from patients recruited from July 18, 2014 to May 9, 2022 in Beijing Tong-Ren Hospital (n = 23, validation cohort). Receiver operating characteristic analysis was used to estimate model accuracy. Results The parameters in this new model included PLT > 289.5(10^9/L) (1 point), Lymphocyte > 1.785(10^9/L) (-1point), Age > 73 years old (1 point), Calcium > 2.145(mmol/L) (-1point), Eastern Cooperative Oncology Group performance status (ECOG PS) > 2 (2 points). When the sum of scores < 0, it is recognized as a low-risk group; when the score is 0 ~ 3, it is recognized as a high-risk group. The survival rate of patients in the high-risk group was significantly lower than that in the low-risk group (hazard ratio [HR], 3.878; 95% confidence interval [CI], 2.226–6.755; P < 0.001). The validation group had similar results (HR,3.574; 95%CI,1.064–12.001; P = 0.039). Furthermore, the areas under the curve 6 months after diagnosis in the two cohorts were 0.900 (95% CI: 0.839–0.962) and 0.761 (95% CI: 0.568–0.954) for development and validation cohorts, respectively. Conclusion We developed a simple, clinically relevant prognostic prediction model for PLACE by evaluating five variables routinely tested at the time of diagnosis. The predictive model can differentiate patients of Chinese ethnicity into different risk groups and further guide prognosis.

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Section: Discussionsupporting

confidence: 93%

“…This also potentially suggests the reason for the low proportion of men in this study. However, in some studies, the proportion of women is as high as 40 − 50% [ 34 , 35 ]. This suggests that the gender proportion of MPM varies in different regions.…”

Section: Discussionmentioning

confidence: 99%

Predicting survival for patients with mesothelioma: development of the PLACE prognostic model

Zhang¹,

Li²,

Li³

et al. 2023

BMC Cancer

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Outcome prediction based on [18F]FDG PET/CT in patients with pleural mesothelioma treated with ipilimumab and nivolumab +/- UV1 telomerase vaccine

Thunold,

Hernes,

Farooqi

et al. 2024

Eur J Nucl Med Mol Imaging

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Purpose The introduction of immunotherapy in pleural mesothelioma (PM) has highlighted the need for effective outcome predictors. This study explores the role of [18F]FDG PET/CT in predicting outcomes in PM treated with immunotherapy. Methods Patients from the NIPU trial, receiving ipilimumab and nivolumab +/- telomerase vaccine in second-line, were included. [18F]FDG PET/CT was obtained at baseline (n = 100) and at week-5 (n = 76). Metabolic tumour volume (MTV) and peak standardised uptake value (SUVpeak) were evaluated in relation to survival outcomes. Wilcoxon rank-sum test was used to assess differences in MTV, total lesion glycolysis (TLG), maximum standardised uptake value (SUVmax) and SUVpeak between patients exhibiting an objective response, defined as either partial response or complete response according to the modified Response Criteria in Solid Tumours (mRECIST) and immune RECIST (iRECIST), and non-responders, defined as either stable disease or progressive disease as their best overall response. Results Univariate Cox regression revealed significant associations of MTV with OS (HR 1.36, CI: 1.14, 1.62, p < 0.001) and PFS (HR 1.18, CI: 1.03, 1.34, p = 0.02), while multivariate analysis showed a significant association with OS only (HR 1.35, CI: 1.09, 1.68, p = 0.007). While SUVpeak was not significantly associated with OS or PFS in univariate analyses, it was significantly associated with OS in multivariate analysis (HR 0.43, CI: 0.23, 0.80, p = 0.008). Objective responders had significant reductions in TLG, SUVmax and SUVpeak at week-5. Conclusion MTV provides prognostic value in PM treated with immunotherapy. High SUVpeak was not associated with inferior outcomes, which could be attributed to the distinct mechanisms of immunotherapy. Early reductions in PET metrics correlated with treatment response. Study registration The NIPU trial (NCT04300244) is registered at clinicaltrials.gov. https://classic.clinicaltrials.gov/ct2/show/NCT04300244?cond=Pleural+Mesothelioma&cntry=NO&draw=2&rank=4

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The role of radiotherapy in the treatment of malignant pleural mesothelioma - possibilities and controversy

Arsenijevic,

Stepanovic,

Nikitovic

2024

Srp Arh Celok Lek

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Malignant pleural mesothelioma (MPM) is a rare malignancy with a poor prognosis. In recent years, significant progress has been made in the treatment of this disease, including surgical and radiotherapy techniques, systemic and immunotherapy. Due to the wide range of clinical presentations, lack of phase III randomized trials, and heterogeneity in treatment approach, the treatment of malignant pleural mesothelioma remains challenging regardless of available diagnostic and therapeutic guidelines. The limited possibility to avoid critical healthy organs (particularly lungs) which can lead to severe, and even fatal radiation-induced toxicity, makes high-dose radical radiotherapy very demanding. Thus, the majority of patients in the era of conventional radiotherapy were mostly referred to no more than palliative radiotherapy only. Technological development in radiotherapy such as respiratory gating, 4D computed tomography (4DCT), intensity-modulated radiotherapy (IMRT), volumetric modulated arc therapy (VMAT), stereotactic techniques, and proton therapy, made a step forward in treating malignant pleural mesothelioma with this modality. Today, MPM radiotherapy can be considered in various indications, alone or in combination with surgery and systemic treatment. However, many questions remain open, and further investigation is needed especially in dose escalation possibility and lung sparing.

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Factors affecting the life expectancy in malignant pleural mesothelioma: Our 10 years of studies and experience

Cited by 4 publications

References 29 publications

Predicting survival for patients with mesothelioma: development of the PLACE prognostic model

Predicting survival for patients with mesothelioma: development of the PLACE prognostic model

Outcome prediction based on [18F]FDG PET/CT in patients with pleural mesothelioma treated with ipilimumab and nivolumab +/- UV1 telomerase vaccine

The role of radiotherapy in the treatment of malignant pleural mesothelioma - possibilities and controversy

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