Comment on "EURACAN/IASLC proposals for updating the histologic classification of pleural mesothelioma: towards a more multidisciplinary approach"

Our plain-English summary of Comment on "EURACAN/IASLC proposals for updating the histologic classification of pleural mesothelioma: towards a more multidisciplinary approach", by W.T. Vigneswaran, M. Kittaneh (Translational Lung Cancer Research, 2020).

The study

• Authors: W.T. Vigneswaran, M. Kittaneh
• Journal: Translational Lung Cancer Research
• Published: 2020;9(6):2508-2510
• Type of article: Editorial, Comment
• Cited by: 1 article, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

In plain English

This was an editorial commentary, not a study; the authors reported no patient data of their own. It responded to proposals by Nicholson and colleagues (Journal of Thoracic Oncology, 2020) for updating how pleural mesothelioma is classified under the microscope. The authors welcomed the proposals' attention to tissue sampling and to reporting features such as architecture, nuclear grading and histological characteristics. They wrote that it is not uncommon for patients to be referred to specialized centers with suboptimal pathology reports, and argued that patients should be managed in specialized mesothelioma centers. They wrote that the search for actionable biomarkers had not yet produced level 1 evidence or FDA approved therapies. They described a separate study by Hassan and colleagues, which suggested that patients with pleural mesothelioma with loss-of-function mutations in BAP1 and other DNA repair genes appeared to benefit from platinum chemotherapy, compared with patients without inherited mutations. They also listed ongoing biomarker-driven trials. The authors concluded that biomarker-driven clinical trials are strongly needed. The commentary did not discuss asbestos. It was commissioned and did not undergo external peer review.

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: Editorial commentary on a published pathology classification proposal; no original data
• Who was studied: No patients studied; the commentary concerns the EURACAN/IASLC proposals by Nicholson et al. for classifying pleural mesothelioma
• Main results:
  • The authors' view: the proposals cover pathology reporting of features that are prognostic markers, including architecture, nuclear grading and histological characteristics
  • The authors' observation: it is not uncommon for patients to be referred to specialized centers with suboptimal pathology reports that lack basic details
  • The authors' view: patients with mesothelioma should be managed in specialized mesothelioma centers
  • The authors' statement: efforts to find actionable biomarkers had not yet produced level 1 evidence or FDA approved therapies
  • Another study's finding, as described by the authors (Hassan et al.): patients with pleural mesothelioma with loss-of-function mutations in BAP1 and other DNA repair genes appeared to benefit from platinum chemotherapy, compared with patients without inherited mutations
  • The authors described the MiST Phase II trial and tabulated six ongoing trials targeting BAP1 loss or NF2 mutation
• The authors' conclusion: The authors concluded that biomarker-driven clinical trials are strongly needed. In their view, traditional histologic classification has not significantly changed treatment standards in two decades.

Topics

Medical terms in this study, explained in our Lexicon: IASLC, Pleural Mesothelioma, Multidisciplinary Team.

Related studies

• The IASLC Mesothelioma Staging Project: Proposals for the M Descriptors and for Revision of the TNM Stage Groupings in the Forthcoming (Eighth) Edition of the TNM Classification for Mesothelioma — V.W. Rusch, K. Chansky, et al. (2016)
• The IASLC Mesothelioma Staging Project: Proposals for Revisions of the N Descriptors in the Forthcoming Eighth Edition of the TNM Classification for Pleural Mesothelioma — D. Rice, K. Chansky, et al. (2016)
• Guidelines for the cytopathologic diagnosis of epithelioid and mixed-type malignant mesothelioma: Complementary statement from the international mesothelioma interest group, also endorsed by the international academy of cytology and the papanicolaou society of cytopathology. A proposal to be applauded and promoted but which requires updating — M. Sheaff (2020)
• Histologic classification and differential diagnosis of mesothelioma — D. Carter (1981)
• Rethought histologic classification of pleural mesothelioma to better treat: go forward from looking back — P. Astoul (2020)
• The Importance of Multidisciplinary Approach in Early Detection of BAP1 Tumor Predisposition Syndrome: Clinical Management and Risk Assessment — A. Battaglia (2014)

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