Malignant mesothelioma tumours: molecular pathogenesis, diagnosis, and therapies accompanying clinical studies

Our plain-English summary of Malignant mesothelioma tumours: molecular pathogenesis, diagnosis, and therapies accompanying clinical studies, by R.K. Sahu, S. Ruhi, A.K. Jeppu, et al (Frontiers in Oncology, 2023).

The study

• Authors: R.K. Sahu, S. Ruhi, A.K. Jeppu, H.A. Al-Goshae, A. Syed, S. Nagdev, R. Widyowati, W. Ekasari, J. Khan, B. Bhattacharjee, M. Goyal, S. Bhattacharya, R.K. Jangde
• Journal: Frontiers in Oncology
• Published: 2023;13:1204722
• Type of article: Review
• Cited by: 21 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

The pathetic malignant mesothelioma (MM) is a extremely uncommon and confrontational tumor that evolves in the mesothelium layer of the pleural cavities (inner lining- visceral pleura and outer lining- parietal pleura), peritoneum, pericardium, and tunica vaginalis and is highly resistant to standard treatments. In mesothelioma, the predominant pattern of lesions is a loss of genes that limit tumour growth. Despite the worldwide ban on the manufacture and supply of asbestos, the prevalence of mesothelioma continues to increase. Mesothelioma presents and behaves in a variety of ways, making diagnosis challenging. Most treatments available today for MM are ineffective, and the median life expectancy is between 10 and 12 months. However, in recent years, considerable progress has already been made in understanding the genetics and molecular pathophysiology of mesothelioma by addressing hippo signaling pathway. The development and progression of MM are related to many important genetic alterations. This is related to NF2 and/or LATS2 mutations that activate the transcriptional coactivator YAP. The X-rays, CT scans, MRIs, and PET scans are used to diagnose the MM. The MM are treated with surgery, chemotherapy, first-line combination chemotherapy, second-line treatment, radiation therapy, adoptive T-cell treatment, targeted therapy, and cancer vaccines. Recent clinical trials investigating the function of surgery have led to the development of innovative approaches to the treatment of associated pleural effusions as well as the introduction of targeted medications. An interdisciplinary collaborative approach is needed for the effective care of persons who have mesothelioma because of the rising intricacy of mesothelioma treatment. This article highlights the key findings in the molecular pathogenesis of mesothelioma, diagnosis with special emphasis on the management of mesothelioma.

Copyright © 2023 Sahu, Ruhi, Jeppu, Al-Goshae, Syed, Nagdev, Widyowati, Ekasari, Khan, Bhattacharjee, Goyal, Bhattacharya and Jangde.

In plain English

This article was a review, not a new study. The authors summarized published research on malignant mesothelioma's causes, molecular biology, symptoms, diagnosis and treatment. They also compiled a table of mesothelioma clinical trials retrieved from ClinicalTrials.gov on May 15, 2023. Citing other work, the review described asbestos as the main cause of mesothelioma. It stated that occupational asbestos exposure causes 85 percent of cases in men, and that the influence of the SV40 virus had not been established. It reported a median life expectancy of 10 to 12 months. It described genetic changes such as NF2 mutations, which it said occur in about half of tumours, and the Hippo signaling pathway. It also covered imaging, blood and fluid biomarkers, surgery, chemotherapy, radiation, immunotherapy, cell therapies and vaccines. For most trials in the table, results were listed as not mentioned. The authors concluded that new, effective treatments are urgently needed, although drugs targeting immune checkpoints and blood-vessel growth have shown promising effects.

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: Narrative review of published literature, with a table of clinical trials compiled from ClinicalTrials.gov
• Who was studied: No study population of its own. The review covered published research on malignant mesothelioma and clinical trials listed on ClinicalTrials.gov, searched on May 15, 2023.
• Exposure: Asbestos as the main cause of mesothelioma. The review named six regulated asbestos fibers (crocidolite, actinolite, tremolite, anthophyllite, amosite, chrysotile) and mentioned crocidolite (Cape Blue) mining in South Africa. It also discussed Simian virus 40 (SV40) as a possible factor.
• Main results:
  • Citing other work, the review stated that mesothelioma in men is caused by occupational asbestos exposure in 85 percent of cases.
  • The review stated that the influence of SV40 on the development of mesothelioma has not been established and that asbestos remains the main cause.
  • The review stated that median life expectancy for people with malignant mesothelioma is between 10 and 12 months.
  • The review stated that about half of malignant mesothelioma tumours carry mutations in the NF2 tumour suppressor gene.
  • Describing an earlier randomized trial, the review reported a median survival of 12.1 months in the pemetrexed group versus 9.3 months in the cisplatin group.
  • In the authors' table of mesothelioma clinical trials from ClinicalTrials.gov, results were listed as not mentioned for most trials.
• The authors' conclusion: The authors concluded that there remains an urgent need for new and effective treatments, although drugs targeting immune checkpoints and angiogenesis have shown promising effects.

Topics

Medical terms in this study, explained in our Lexicon: Malignant Mesothelioma, Mesothelium, Visceral Pleura, Parietal Pleura, Peritoneum, Pericardium, Tunica Vaginalis, Mesothelioma.

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• Malignant pleural mesothelioma: newer aspects of carcinogenesis, molecular genetics, and prospects for future therapies — J.S. Donington, D.J. Mew, et al. (1995)
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