Malignant pleural mesothelioma: from the bench to the bedside

Our plain-English summary of Malignant pleural mesothelioma: from the bench to the bedside, by P. Astoul, E. Roca, F. Galateau-Salle, et al (Respiration; International Review of Thoracic Diseases, 2012).

The study

• Authors: P. Astoul, E. Roca, F. Galateau-Salle, A. Scherpereel
• Journal: Respiration; International Review of Thoracic Diseases
• Published: 2012;83(6):481-93
• Type of article: Review
• Cited by: 38 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Optimal management of malignant pleural mesothelioma (MPM), which is mainly based on patient characteristics and clinical stage, is not clearly defined yet, although detailed, practical guidelines for these patients have been proposed by some scientific societies. Translational research, in the field of this disease, is currently in progress and different molecular oncogenic pathways leading to the growth and progression of MPM have been characterized with recent pharmaceutical developments. However, further in-depth analysis still needs to be done for a more advanced deciphering of the step-by-step process leading from early increased mesothelial cell proliferation to invasive mesothelioma, from which we are expecting the development of definitively effective therapy. Thus, this review is an overview of the recent advances in the biology of MPM and their potential therapeutic applications in the field of MPM diagnosis and treatment.

Copyright © 2012 S. Karger AG, Basel.

In plain English

This article was a review, not a new study. The authors searched the Medline database for papers from 2000 to 2012 combining mesothelioma or malignant pleural mesothelioma with biology or targeted therapy, and also checked reference lists of recent publications. They described asbestos fiber exposure as widely accepted as the main cause of malignant pleural mesothelioma. They then summarized research on the disease's molecular biology, on markers for diagnosis and outcome, and on new treatments. Among the studies they reported, one found GLUT-1 staining in 40 of 40 mesotheliomas and in none of 40 cases of reactive mesothelial hyperplasia. The review stated that the value of non-invasive markers for diagnosis remained to be determined. Among the treatment trials it summarized, a phase III trial comparing vorinostat with placebo in 660 previously treated patients did not show a statistically significant overall survival benefit. The authors concluded that recent advances were encouraging but that further research was needed. They also concluded that all patients with this cancer should be recruited into clinical trials and research studies.

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 on the biology, diagnosis and treatment of malignant pleural mesothelioma, based on a Medline search (2000–2012) plus a manual search of reference lists
• Who was studied: Published studies (2000–2012) on mesothelioma and malignant pleural mesothelioma in relation to biology or targeted therapy, found through Medline and the reference lists of recent publications; the review covers laboratory studies, cell lines, animal models and clinical trials reported by others
• Exposure: The review does not study an exposure itself. It states that asbestos fiber exposure is widely accepted as the main cause of malignant pleural mesothelioma, and that other mineral fibers such as erionite, SV40 and radiation have been reported in low evidence-based reports. No specific asbestos fiber types are discussed in the body of the text.
• Main results:
  • The review cites a study by Kato et al. in which GLUT-1 staining was found in 40 of 40 mesotheliomas, while all 40 cases of reactive mesothelial hyperplasia were negative.
  • The review cites a study by Shi et al. in which IMP3 was negative in all 64 reactive mesothelial lesions and positive in 33 of 45 (73%) malignant mesotheliomas.
  • The review stated that studies of non-invasive markers for diagnosing mesothelioma were of limited value, with inconclusive results.
  • In a cited series of 206 malignant pleural mesothelioma tissue samples, PTEN protein expression was lost in 62% of cases.
  • In a cited phase II trial of erlotinib in 63 chemotherapy-naïve patients with advanced or recurrent malignant pleural mesothelioma, there were no responses. 14 of 33 (42%) patients had stable disease, and the trial's authors concluded that single-agent erlotinib was not effective.
  • In a cited phase III trial (Vantage 014) of vorinostat versus placebo in 660 pretreated mesothelioma patients, median progression-free survival was 6.3 weeks with vorinostat versus 6.1 weeks. This did not translate into a statistically significant overall survival benefit.
  • In a cited phase II study by Scherpereel et al. of valproic acid combined with doxorubicin in 45 previously treated patients with malignant pleural mesothelioma, the response rate was 16% (95% CI 3–25%) and the disease control rate was 36% (95% CI 22–51%). Overall survival was 6.7 months (95% CI 4.9–8.5 months).
• The authors' conclusion: The authors concluded that studies over the last 5 years had brought encouraging advances. They said further analysis is needed of the process leading from early mesothelial cell proliferation to invasive mesothelioma, and that all patients with malignant pleural mesothelioma should be recruited into clinical trials and research studies.
• Limitations the authors state:
  • The authors state that abstracts from oncology meetings were not included in the review's reference list.

Topics

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

Medical terms in this study, explained in our Lexicon: Pleural Mesothelioma, Mesothelial Cells, Mesothelioma.

Related studies

• Progress and challenges in Mesothelioma: From bench to bedside — K.G. Blyth, D.J. Murphy (2018)
• Diagnostic usefulness of EMA, IMP3, and GLUT-1 for the immunocytochemical distinction of malignant cells from reactive mesothelial cells in effusion cytology using cytospin preparations — K. Ikeda, G. Tate, et al. (2011)
• Comparative immunohistochemical analysis of IMP3, GLUT1, EMA, CD146, and desmin for distinguishing malignant mesothelioma from reactive mesothelial cells — H. Minato, N. Kurose, et al. (2014)
• IMP3 and GLUT-1 immunohistochemistry for distinguishing benign from malignant mesothelial proliferations — A.F. Lee, A.M. Gown, et al. (2013)
• Practical utility of insulin-like growth factor II mRNA-binding protein 3, glucose transporter 1, and epithelial membrane antigen for distinguishing malignant mesotheliomas from benign mesothelial proliferations — S. Chang, M.H. Oh, et al. (2014)
• Value of Glut-1 and Koc markers in the differential diagnosis of reactive mesothelial hyperplasia, malignant mesothelioma and pulmonary adenocarcinoma — Ö. Üçer, A.F. Dağli, et al. (2013)

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