Incidence, mortality and survival in malignant pleural mesothelioma before and after asbestos in Denmark, Finland, Norway and Sweden

Hemminki, Kari; Försti, Asta; Chen, Tianhui; Hemminki, Akseli

doi:10.1186/s12885-021-08913-2

Cited by 16 publications

(15 citation statements)

References 43 publications

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“…We speculate that the pre-ban MR of the ‘early-banned countries’ was also in the upper range of that of the ‘banned & identified’ countries. This speculation is supported by our observation that the pre-ban standardised incidence rates of male pleural mesothelioma in the early-banned countries of Denmark, Norway and Sweden were higher than or similar to that of Finland, 29 which had an upper range pre-ban MR of the ‘banned and identified’ countries. Thus, the associations of asbestos bans with mesothelioma MR and identification found in this study would likely be strengthened if we could include the ‘early-banned’ countries in the main analysis.…”

Section: Discussionmentioning

confidence: 53%

Must countries shoulder the burden of mesothelioma to ban asbestos? A global assessment

et al. 2022

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IntroductionMesothelioma is a key asbestos-related disease (ARD) but can be difficult to diagnose. Countries presumably ban asbestos to reduce future ARD burdens, but it is unknown if countries ban asbestos as a consequence of ARD burdens. We assessed if and to what extent mesothelioma burden has an impact on a country banning asbestos and obtaining targets for preventative strategies.MethodsWe analysed the status of asbestos ban and mesothelioma burden during 1990–2019 in 198 countries. We assessed mesothelioma burden by age-adjusted mortality rates (MRs) estimated by the Global Burden of Disease Study (GBD) and mesothelioma identification by the WHO mortality database. For GBD-estimated mesothelioma MR, the pre-ban period in the asbestos-banned countries was compared with the 1990–2019 period in the not-banned countries. For mesothelioma identification, the 1990–2019 period was applied to both banned and not-banned countries.ResultsThe association of mesothelioma MR with ban status increased as the ban year approached. Logistic regression analyses showed that the odds of a country banning asbestos increased 14.1-fold (95% CI 5.3 to 37.9) for mesothelioma identification combined with a 26% (12% to 42%) increase per unit increase of mesothelioma MR (one death per million per year) during the period 1–5 year before ban (model p<0.0001).ConclusionMesothelioma burden had an impact on, and together with its identification, explained the banning of asbestos in many countries. Asbestos-banned countries likely learnt lessons from their historical policies of using asbestos because mesothelioma burden and identification follow historical asbestos use. Prevention targets for ARD elimination should combine asbestos ban with mesothelioma identification.

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Section: Discussionmentioning

confidence: 53%

Must countries shoulder the burden of mesothelioma to ban asbestos? A global assessment

et al. 2022

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“…The peak incidence of mesothelioma in Finland was reported to have occurred in 2006, and this country was one of the rst in Europe to implement a law outlawing the use of asbestos early in 1992 (17). Moreover, Sweden was among the rst nations in the world where the incidence of MPM began to decline very early in 1995 (17). Although MM mortality in the Netherlands was predicted to peak around 2020, a recent analysis suggested that MM incidence peaked earlier in 2010 (15,30,31).…”

Section: Discussionmentioning

confidence: 99%

Asbestos Ban Policies and Mesothelioma Mortality in Greece

Gogou,

Hatzoglou,

Siachpazidou

et al. 2023

Preprint

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Background Malignant mesothelioma is a rare form of cancer that mostly affects the pleura and has a strong link to asbestos exposure. Greece banned the use of asbestos in 2005, however, the public was already aware of this substance in the 1980s. This research aims to present an overview of Greece's mesothelioma mortality rates (MMR) from 1983 to 2019 by age, gender, and geographic region and to determine whether the actions to ban asbestos impacted these rates. Methods Data were retrieved by the Hellenic Statistical Authority (HAS) from death certificates that mentioned mesothelioma as the cause of death from 1983 to 2019 with details on the residence, gender, and age. Statistical analysis was performed using SPSS 29 software, a one-way ANOVA test followed by post-hoc and Dunnett C test for multiple comparisons or Independent samples T-test for comparison between two subjects. Results Males' MMR and the whole population's MMR reached their highest levels in 2011 (0.86/100000 and 0.52/100000, respectively). In order to look for any potential changes between the first two decades of the 21st century, we compared the mean MMR of each geographic region in Greece between two different 10-year subperiods (2000–2009 and 2010–2019). Except for Epirus, all regions of Greece had elevated regional MMRs, particularly in those with the highest asbestos deposits. Notably, the MMR in Epirus decreased from 0.55/100000 (2000–2009) to 0.38/100000 (2010–2019). After 2011, the MMR for men and the general population stabilized. This stability is important since mesothelioma in men is associated with occupational asbestos exposure. The intriguing discovery of a lower MMR in Epirus emphasizes the need to raise awareness of the condition and implement effective public health measures. Conclusions In Greece, the annual rate for males and the whole population reached its highest level in 2011, which is positive and encouraging and may be a sign that the rate will stabilize during the following years. Moreover, this study showed that the actions made in the 1980s regarding public awareness and surveillance directly impacted the decrease in Epirus rates. Future research, continual awareness, information, and recording are needed to monitor the mesothelioma epidemic. Trial registration: Not applicable

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“…MPM is an aggressive tumor associated with a low 5-year survival rate (≤10%). 23 24 This study was conducted prior to the recent approval of an immunotherapy regimen, and pemetrexed and platinum chemotherapy was a first-line standard of care for patients with unresectable MPM. 24 Several studies support rechallenge with a platinum plus pemetrexed regimen in patients with mesothelioma following an initial favorable response.…”

Section: Discussionmentioning

confidence: 99%

ONCOS-102 plus pemetrexed and platinum chemotherapy in malignant pleural mesothelioma: a randomized phase 2 study investigating clinical outcomes and the tumor microenvironment

Ponce,

Cedrés,

Ricordel

et al. 2023

J Immunother Cancer

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BackgroundONCOS-102, an oncolytic adenovirus expressing granulocyte-macrophage colony-stimulating factor, can alter the tumor microenvironment to an immunostimulatory state. Combining ONCOS-102 with standard-of-care chemotherapy for malignant pleural mesothelioma (MPM) may improve treatment outcomes.MethodsIn this open-label, randomized study, patients with unresectable MPM received intratumoral ONCOS-102 (3×1011virus particles on days 1, 4, 8, 36, 78, and 120) and pemetrexed plus cisplatin/carboplatin (from day 22), or pemetrexed plus cisplatin/carboplatin alone. The primary endpoint was safety. Overall survival (OS), progression-free survival, objective response rate, and tumor immunologic activation (baseline and day 36 biopsies) were also assessed.ResultsIn total, 31 patients (safety lead-in: n=6, randomized: n=25) were enrolled. Anemia (15.0% and 27.3%) and neutropenia (40.0% and 45.5%) were the most frequent grade ≥3 adverse events (AEs) in the ONCOS-102 (n=20) and chemotherapy-alone (n=11) cohorts. No patients discontinued ONCOS-102 due to AEs. No statistically significant difference in efficacy endpoints was observed. There was a numerical improvement in OS (30-month OS rate 34.1% vs 0; median OS 20.3 vs 13.5 months) with ONCOS-102 versus chemotherapy alone in chemotherapy-naïve patients (n=17). By day 36, ONCOS-102 was associated with increased T-cell infiltration and immune-related gene expression that was not observed in the control cohort. Substantial immune activation in the tumor microenvironment was associated with survival at month 18 in the ONCOS-102 cohort.ConclusionsONCOS-102 plus pemetrexed and cisplatin/carboplatin was well tolerated by patients with MPM. In injected tumors, ONCOS-102 promoted a proinflammatory environment, including T-cell infiltration, which showed association with survival at month 18.

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Incidence, mortality and survival in malignant pleural mesothelioma before and after asbestos in Denmark, Finland, Norway and Sweden

Cited by 16 publications

References 43 publications

Must countries shoulder the burden of mesothelioma to ban asbestos? A global assessment

Must countries shoulder the burden of mesothelioma to ban asbestos? A global assessment

Asbestos Ban Policies and Mesothelioma Mortality in Greece

ONCOS-102 plus pemetrexed and platinum chemotherapy in malignant pleural mesothelioma: a randomized phase 2 study investigating clinical outcomes and the tumor microenvironment

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