Commentary: Not only SMART clinically, but translationally!

Our plain-English summary of Commentary: Not only SMART clinically, but translationally!, by H.I. Pass (The Journal of Thoracic and Cardiovascular Surgery, 2020).

The study

• Author: H.I. Pass
• Journal: The Journal of Thoracic and Cardiovascular Surgery
• Published: 2020;159(5):2094-2095
• Type of article: Editorial, Comment
• Cited by: 2 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

In plain English

This is a short commentary, not a research study, and it reports no new data. It does not discuss asbestos exposure. The author wrote about a separate study by de Perrot and colleagues. That study examined the tumor microenvironment, meaning the immune and other cells around a tumor, in malignant pleural mesothelioma after a treatment approach called SMART. SMART is radiation given before surgery, followed by extrapleural pneumonectomy, an operation to remove the lung and the lining of the chest. The author described that study as the first in human mesothelioma to look at the baseline effects of this hypofractionated radiation without other pre-surgery treatments. The author noted that the original biopsy specimens were not available to compare with the tissue removed at surgery, and that this comparison is planned for future studies. The author listed questions for future research. These included what kind of CD8 T cells (immune cells that can attack tumors) are present and why they appeared "decreased" after radiation. The author concluded that future studies of this kind would help surgeons and immunotherapists personalize and improve treatment for pleural mesothelioma.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Commentary (opinion piece) on another published study; no original data
• Who was studied: No population was studied in this article. It comments on a study by de Perrot and colleagues of the tumor microenvironment in malignant pleural mesothelioma (MPM) after preoperative radiation and surgery.
• Exposure: Not asbestos. The treatment discussed is preoperative hypofractionated radiation followed by extrapleural pneumonectomy (the SMART protocol) for mesothelioma.
• The authors' conclusion: The author concluded that future translational and mechanistic studies of immune cells would allow immunotherapists and surgeons to personalize and improve therapies for pleural mesothelioma.
• Limitations the authors state:
  • The author noted that the study under discussion did not have the original biopsy specimens to compare with the SMART specimens taken at surgery, and that this comparison is planned for later studies.
  • The author stated that future studies must determine the type and function of the CD8 T cells and why they appeared decreased after radiation.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Lung cancer, Mesothelioma.

Related studies

• Commentary: A journey of a thousand miles begins with a single step — T.F. Chen-Yoshikawa (2020)
• SMART: logical radiotherapy and surgery beyond MARS — H.I. Pass (2021)
• A feasibility study evaluating Surgery for Mesothelioma After Radiation Therapy: the "SMART" approach for resectable malignant pleural mesothelioma — B.C. Cho, R. Feld, et al. (2014)
• Prophylactic radiotherapy for the prevention of procedure-tract metastases after surgical and large-bore pleural procedures in malignant pleural mesothelioma (SMART): a multicentre, open-label, phase 3, randomised controlled trial — A.O. Clive, H. Taylor, et al. (2016)
• Thymidylate synthase and folyl-polyglutamate synthase are not clinically useful markers of response to pemetrexed in patients with malignant pleural mesothelioma — D.E. Lustgarten, C. Deshpande, et al. (2013)
• Surgery for malignant pleural mesothelioma after radiotherapy (SMART): final results from a single-centre, phase 2 trial — B.C.J. Cho, L. Donahoe, et al. (2021)

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