Targeting microRNA to improve diagnostic and therapeutic approaches for malignant mesothelioma

Our plain-English summary of Targeting microRNA to improve diagnostic and therapeutic approaches for malignant mesothelioma, by K.A. Birnie, C.M. Prêle, P.J. Thompson, et al (Oncotarget, 2017).

The study

• Authors: K.A. Birnie, C.M. Prêle, P.J. Thompson, B. Badrian, S.E. Mutsaers
• Journal: Oncotarget
• Published: 2017;8(44):78193-78207
• Type of article: Review
• Cited by: 17 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Malignant mesothelioma is an aggressive and often fatal cancer associated with asbestos exposure. The disease originates in the mesothelial lining of the serosal cavities, most commonly affecting the pleura. Survival rates are low as diagnosis often occurs at an advanced stage and current treatments are limited. Identifying new diagnostic and therapeutic targets for mesothelioma remains a priority, particularly for the new wave of victims exposed to asbestos through do-it-yourself renovations and in countries where asbestos is still mined and used. Recent advances have demonstrated a biological role for the small but powerful gene regulators microRNA (miRNA) in mesothelioma. A number of potential therapeutic targets have been identified. MiRNA have also become popular as potential biomarkers for mesothelioma due to their stable expression in bodily fluid and tissues. In this review, we highlight the current challenges associated with the diagnosis and treatment of mesothelioma and discuss how targeting miRNA may improve diagnostic, prognostic and therapeutic approaches.

In plain English

This article is a narrative review, not a new study. The authors summarised published research on microRNA (miRNA), small molecules that regulate genes, in malignant pleural mesothelioma and malignant peritoneal mesothelioma. They described mesothelioma as strongly associated with asbestos exposure, but the review did not examine asbestos exposure itself, and the article does not say how the studies were chosen. The authors reported that most of the miRNA they described were downregulated (found at lower levels) in pleural mesothelioma, and they suggested chromosomal abnormalities as the likely cause. They described an early-stage (Phase I) clinical trial of a miR-16 treatment. According to its preliminary results, four of six patients had stable disease and one had a partial response after eight weeks. They also reviewed studies testing miRNA in tissue, blood and pleural fluid as possible diagnostic or survival markers, and said larger prospective studies are needed to confirm those findings. For peritoneal mesothelioma, they described one study, on miR-34a. The authors concluded that results are often not reproducible across studies and called for standardised methods and large collaborative sample groups.

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 research on microRNA in mesothelioma; no search or selection method is described
• Who was studied: Published laboratory, animal and human studies of microRNA in malignant pleural mesothelioma (MPM) and malignant peritoneal mesothelioma (PMM); the number of studies reviewed is not stated
• Exposure: Asbestos is mentioned only as background (mesothelioma is described as strongly associated with asbestos exposure); no fiber types, jobs or doses are studied. The review's subject is microRNA in mesothelioma.
• Main results:
  • Most of the miRNA described in the review were downregulated in pleural mesothelioma and were proposed as potential tumour suppressors; the authors suggested chromosomal abnormalities as the likely cause
  • Preliminary results reported from the Phase I MesomiR 1 trial of miR-16 TargomiRs in pleural mesothelioma patients: all six patients in the initial stages completed treatment; four of the six had stable disease and one had a partial response after eight weeks
  • For blood-based miRNA markers reported in the reviewed studies, the authors said larger prospective studies are needed to validate the findings
  • The authors found only one study on measuring miRNA in pleural effusion to help diagnose pleural mesothelioma
  • For peritoneal mesothelioma, the review described one study of miR-34a in 45 diffuse malignant peritoneal mesothelioma tissues, seven normal peritoneum samples and five cell lines
• The authors' conclusion: The authors concluded that, with advancing technology and more collaborative work, new miRNA-based diagnostic and therapeutic approaches for mesothelioma can be developed
• Limitations the authors state:
  • The authors noted that results on diagnostic and prognostic miRNA often cannot be reproduced across studies, which they attributed to differences in study design
  • The authors stated that the proposed miRNA signatures still need validation studies to assess clinical relevance

Topics

Medical terms in this study, explained in our Lexicon: Malignant Mesothelioma, Asbestos Exposure, Pleura, Mesothelioma, Biomarker.

Related studies

• Asbestos, lung cancers, and mesotheliomas: from molecular approaches to targeting tumor survival pathways — N.H. Heintz, Y.M. Janssen-Heininger, et al. (2010)
• Tumour suppressor microRNAs contribute to drug resistance in malignant pleural mesothelioma by targeting anti-apoptotic pathways — M. Williams, Y.Y. Cheng, et al. (2019)
• Asbestos-induced chronic inflammation in malignant pleural mesothelioma and related therapeutic approaches-a narrative review — A.A. Zolondick, G. Gaudino, et al. (2021)
• Management of malignant pleural mesothelioma-part 2: therapeutic approaches : Consensus of the Austrian Mesothelioma Interest Group (AMIG) — M.A. Hoda, T. Klikovits, et al. (2016)
• Methods to improve the diagnostic accuracy of malignant mesothelioma — A. Dejmek (1996)
• Newly established ELISA for N-ERC/mesothelin improves diagnostic accuracy in patients with suspected pleural mesothelioma — T. Sato, Y. Suzuki, et al. (2014)

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