Translational advances in pleural malignancies

Our plain-English summary of Translational advances in pleural malignancies, by G.T. Stathopoulos (Respirology, 2011).

The study

• Author: G.T. Stathopoulos
• Journal: Respirology
• Published: 2011;16(1):53-63
• Type of article: Review
• Cited by: 11 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Pleural malignancies, including primary malignant pleural mesothelioma and secondary pleural metastasis of various tumours resulting in malignant pleural effusion, are frequent and lethal diseases that deserve devoted translational research efforts for improvements to be introduced to the clinic. This paper highlights select clinical advances that have been accomplished recently and that are based on preclinical research on pleural malignancies. Examples are the establishment of folate antimetabolites in mesothelioma treatment, the use of PET in mesothelioma management and the discovery of mesothelin as a marker of mesothelioma. In addition to established translational advances, this text focuses on recent research findings that are anticipated to impact clinical pleural oncology in the near future. Such progress has been substantial, including the development of a genetic mouse model of mesothelioma and of transplantable models of pleural malignancies in immunocompetent hosts, the deployment of stereological and imaging methods for integral assessment of pleural tumour burden, as well as the discovery of the therapeutic potential of aminobiphosphonates, histone deacetylase inhibitors and ribonucleases against malignant pleural disease. Finally, key obstacles to overcome towards a more rapid advancement of translational research in pleural malignancies are outlined. These include the dissection of cell-autonomous and paracrine pathways of pleural tumour progression, the study of mesothelioma and malignant pleural effusion separately from other tumours at both the clinical and preclinical levels, and the expansion of tissue banks and consortia of clinical research of pleural malignancies.

© 2010 The Author. Respirology © 2010 Asian Pacific Society of Respirology.

In plain English

This was a single-author narrative review of translational research (laboratory work moving toward patient care). It covered malignant pleural mesothelioma (MPM) and malignant pleural effusion (MPE) from cancers spreading to the pleura. It gathered no new exposure data, but noted most MPM is occupation-induced and discussed research on asbestos-exposed people. It drew on the author's earlier reviews and PubMed searches, run 14 August 2010, of the previous 3 years. The first found 1665 papers, of which 374 were selected for full-text review. The second found 5472 more, screened by title only, with 132 selected for full-text review. Topics included markers, gene profiling, imaging, treatments and animal models. One study it discussed, by other researchers, found no mesothelioma among 538 asbestos-exposed people, although 3% had raised blood SMRP levels. The author counted 1429 studies on MPM and 348 on MPE over 3 years, against 17 792, 30 625 and 15 527 on lung, breast and prostate cancer. The author concluded that researchers and clinicians had a long way to go. The author noted editorial restrictions limited discussion to the most relevant articles.

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 and registered trials on pleural malignancies
• Who was studied: Published literature, not patients: PubMed searches on 14 August 2010 limited to the last 3 years. The first search yielded 1665 papers (374 selected for full-text review). The second yielded 5472 additional articles (132 selected for full-text review). ClinicalTrials.gov searches yielded 68 registered studies for 'malignant pleural effusion' and 162 for 'mesothelioma'.
• Exposure: The review collected no new exposure data and names no fiber types. It states that most cases of MPM are occupation-induced. It also discusses research on markers and imaging for screening asbestos-exposed people.
• Main results:
  • Of the 1665 papers from the first PubMed search, 374 were selected for full-text review. The second search added 5472 articles, of which only the titles were studied and 132 were selected for full-text review.
  • Searches of ClinicalTrials.gov found 68 registered studies for malignant pleural effusion and 162 for mesothelioma.
  • The review cited a prospective study by other researchers of 538 asbestos-exposed individuals. In that study, serum soluble mesothelin-related peptides (SMRP) showed low specificity and many false positives. No mesothelioma was detected, although 3% of subjects had elevated serum SMRP.
  • The author stated that pilot studies of low-dose CT were inconclusive but warranted further investigation for MPM screening in asbestos-exposed individuals.
  • The author described the development of a genetic mouse model of MPM as one of the major recent experimental advances. The model was made by combined inactivation of the tumour suppressors p16INK4a, NF2 and Trp53.
  • In the last 3 years, 1429 studies addressed MPM and 348 addressed MPE. This compared with 17 792 studies on lung cancer, 30 625 on breast cancer and 15 527 on prostate cancer.
• The authors' conclusion: The author concluded that, despite recent advances in translational pleural oncology, researchers and clinicians had a long way to go. The author called for more intensive research into the pathobiology, diagnosis and management of malignant pleural diseases. The author also called for clinical studies of MPE to be conducted separately from other patient groups.
• Limitations the authors state:
  • Because of editorial restrictions, only the most pertinent and relevant of the retrieved articles were discussed and referenced.
  • For the second search, only the titles of the articles were studied.

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, Metastasis, Pleural Effusion, Mesothelioma, Discovery, Mesothelin.

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