Discussion

Our plain-English summary of Discussion (The Journal of Thoracic and Cardiovascular Surgery, 2015).

The study

• Journal: The Journal of Thoracic and Cardiovascular Surgery
• Published: 2015;149(6):1546-7
• Type of article: Comment
• Read it: PubMed · Publisher

In plain English

This item is not a research study. It is the published transcript of a question-and-answer discussion that followed a conference presentation of a study by Frischknecht and colleagues. That study looked at two tumor proteins, RRM1 and ERCC1, in patients with pleural mesothelioma treated with induction chemotherapy, surgery called extrapleural pneumonectomy (EPP), and postoperative radiation therapy. Asbestos exposure was not discussed. The discussant, Dr H. Pass, described the study as reporting that a high nuclear RRM1 level was associated with longer progression-free and overall survival, and that low ERCC1 was associated with tumor response and longer survival. The discussant also noted that other groups had measured these proteins with different methods. Dr Opitz, answering for the study group, said all 107 patients analyzed underwent EPP. Dr Opitz said RRM1 and ERCC1 showed no influence on overall survival in univariate analysis, that changes in the markers during treatment had no significant effect on survival, and that combining both markers showed a bigger survival difference. Dr Opitz noted missing data on tumor volume and fluorodeoxyglucose uptake, and too few patients without surgery (14) to analyze.

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: Published transcript of a discussion (questions and answers) following a conference presentation of a study; not an original study itself
• Who was studied: According to the presenter, the study analyzed 107 patients with pleural mesothelioma who all underwent extrapleural pneumonectomy (EPP); place and dates not given in this text
• Exposure: No asbestos exposure was addressed. The factors examined were the tumor protein markers RRM1 and ERCC1 in patients treated with induction chemotherapy, EPP and postoperative radiation therapy in phase II trials
• Main results:
  • As summarized by the discussant (Dr Pass), the study reported that an elevated nuclear RRM1 level, measured by immunohistochemistry, was associated with prolonged progression-free and overall survival in these treated patients
  • As summarized by the discussant, the study reported that low ERCC1 levels were associated with tumor response and increased survival
  • The presenter (Dr Opitz) stated that RRM1 and ERCC1 showed no influence on overall survival in univariate analysis, so no multivariate model was done for overall survival
  • The presenter stated that change in the marker profile during treatment did not show a significant influence on overall or progression-free survival
  • The presenter stated that combining both markers showed an additive effect and a bigger difference in survival (no figures given)
• The authors' conclusion: The presenter said the group believes no single factor should predict a patient's outcome, and that ERCC1 and RRM1 might be added to the group's Multimodality Benefit Score
• Limitations the authors state:
  • Tumor volume was available for only a small subset of patients, so it was not included in the multivariate model
  • Only 14 of the 50 patients who did not undergo EPP had no surgery at all, too few for statistical analysis
  • Fluorodeoxyglucose uptake was not recorded for this patient cohort
  • In patients who received pemetrexed, other markers of sensitivity or resistance were not assessed

Topics

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

Related studies

• Importance of excision repair cross-complementation group 1 and ribonucleotide reductase M1 as prognostic biomarkers in malignant pleural mesothelioma treated with platinum-based induction chemotherapy followed by surgery — L. Frischknecht, M. Meerang, et al. (2015)
• The mesothelioma enigma — R.M. Flores (2015)
• Low ERCC1 expression in malignant pleural mesotheliomas treated with cisplatin and vinorelbine predicts prolonged progression-free survival — Z.G. Zimling, J.B. Sørensen, et al. (2012)
• ERCC1, MLH1, MSH2, MSH6, and βIII-tubulin: resistance proteins associated with response and outcome to platinum-based chemotherapy in malignant pleural mesothelioma — S. Ting, F.D. Mairinger, et al. (2013)
• The issue of studies evaluating biomarkers which predict outcome after pemetrexed-based chemotherapy in malignant pleural mesothelioma — F. Mairinger, C. Vollbrecht, et al. (2013)
• Correlation between TS, MTHFR, and ERCC1 gene polymorphisms and the efficacy of platinum in combination with pemetrexed first-line chemotherapy in mesothelioma patients — T. Powrózek, D.M. Kowalski, et al. (2014)

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