ERS International Congress 2023: highlights from the Thoracic Oncology Assembly

Our plain-English summary of ERS International Congress 2023: highlights from the Thoracic Oncology Assembly, by M.J. Catarata, A.W. Creamer, M. Dias, et al (ERJ Open Research, 2024).

The study

• Authors: M.J. Catarata, A.W. Creamer, M. Dias, S. Toland, M. Chaabouni, K. Verbeke, J. Vieira Naia, M. Hassan, S.B. Naidu, G.A. Lynch, K.G. Blyth, N.M. Rahman, G. Hardavella
• Journal: ERJ Open Research
• Published: 2024;10(1)
• Cited by: 1 article, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Lung cancer is the leading cause of cancer mortality in the world. It greatly affects the patients' quality of life, and is thus a challenge for the daily practice in respiratory medicine. Advances in the genetic knowledge of thoracic tumours' mutational landscape, and the development of targeted therapies and immune checkpoint inhibitors, have led to a paradigm shift in the treatment of lung cancer and pleural mesothelioma. During the 2023 European Respiratory Society Congress in Milan, Italy, experts from all over the world presented their high-quality research and reviewed best clinical practices. Lung cancer screening, management of early stages of lung cancer, application of artificial intelligence and biomarkers were discussed and they will be summarised here.

Copyright ©The authors 2024.

In plain English

This article is a congress highlights review, not an original study. The authors summarised research presented at the 2023 European Respiratory Society (ERS) Congress in Milan, Italy. It covered lung cancer screening, early-stage lung cancer, artificial intelligence, biomarkers, and pleural mesothelioma and malignant pleural effusion. Asbestos appears only once: the article noted that a study called Meso-Origins will follow patients with asbestos-associated pleural inflammation. Among the mesothelioma findings it reported from other studies, high levels of mesothelin (a protein) in pleural fluid were associated with a later diagnosis of pleural mesothelioma in 185 patients with non-specific pleuritis. In a study of 209 patients, changes in blood (serum) mesothelin over time predicted survival, progression and response. The article also reported that the MARS2 trial found that adding extended pleurectomy decortication, a type of surgery, to chemotherapy increased the risk of death and serious adverse events. The authors said several findings need replication or external validation. They concluded that pleural disease remains a constant challenge, but that new clinical trials give hope for better survival and quality of life.

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: Congress highlights review (narrative summary of research presented at a scientific meeting); commissioned, peer-reviewed article
• Who was studied: No study population of its own; the article reviewed research presented at the 2023 ERS Congress in Milan, Italy, on lung cancer and pleural disease
• Exposure: Asbestos exposure was not studied. The only mention is a planned or ongoing study (Meso-Origins) following patients with asbestos-associated pleural inflammation.
• Main results:
  • Cited from another source: 12% of individuals diagnosed with non-specific pleuritis developed pleural mesothelioma within 2 years
  • Congress study: in 185 patients with non-specific pleuritis, high pleural fluid mesothelin (above 20 nmol per litre) was associated with eventual pleural mesothelioma diagnosis (OR 31.2, 95% CI 8.5 to 114.7)
  • Congress study of 209 mesothelioma patients: serial serum mesothelin changes predicted survival (adjusted HR 2.28, 95% CI 1.31 to 3.93), progression (adjusted OR 1.51, 1.01 to 1.95) and disease response (adjusted OR 1.40, 1.03 to 1.92)
  • Congress study of 15 patients: six volatile organic compounds in exhaled breath differentiated between stable and progressive disease
  • MARS2 trial: adding extended pleurectomy decortication to chemotherapy increased the risk of death and serious adverse events
  • Mesothelioma in situ: a small case series suggested median progression to pleural mesothelioma after 60 months (range 12 to 92)
  • After the Scottish Mesothelioma Network was set up in 2019, survival improved for non-epithelioid pleural mesothelioma, not fully explainable by the introduction of immunotherapy
• The authors' conclusion: The authors concluded that pleural disease remains a constant challenge, but that new clinical trials give hope for better survival and quality of life in these patients
• Limitations the authors state:
  • The serum mesothelin and exhaled-breath monitoring findings need replication and validation in larger populations
  • The proteomic diagnostic technique for pleural mesothelioma requires external validation
  • Evidence on progression of mesothelioma in situ is limited
  • There is little robust data on treatment of early-stage pleural mesothelioma, because most studies included later-stage disease

Topics

Medical terms in this study, explained in our Lexicon: Lung Cancer, Quality of Life, checkpoint inhibitors, Pleural Mesothelioma, Low-Dose CT Screening, Biomarker.

Related studies

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• The role of surgical cytoreduction in the treatment of malignant pleural mesothelioma: meeting summary of the International Mesothelioma Interest Group Congress, September 11-14, 2012, Boston, Mass — V. Rusch, E.H. Baldini, et al. (2013)
• Highlights of the 14th international mesothelioma interest group meeting: Pathologic separation of benign from malignant mesothelial proliferations and histologic/molecular analysis of malignant mesothelioma subtypes — A. Churg, K. Nabeshima, et al. (2018)
• The role of radiation treatment in pleural mesothelioma: Highlights of the 14th International Conference of the International mesothelioma interest group — R.M. MacRae, M. Ashton, et al. (2019)
• Assessing Tumor-Infiltrating Lymphocytes in Solid Tumors: A Practical Review for Pathologists and Proposal for a Standardized Method from the International Immuno-Oncology Biomarkers Working Group: Part 2: TILs in Melanoma, Gastrointestinal Tract Carcinomas, Non-Small Cell Lung Carcinoma and Mesothelioma, Endometrial and Ovarian Carcinomas, Squamous Cell Carcinoma of the Head and Neck, Genitourinary Carcinomas, and Primary Brain Tumors — S. Hendry, R. Salgado, et al. (2017)
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