Pleural Mesothelioma: Treatable Traits of a Heterogeneous Disease

Our plain-English summary of Pleural Mesothelioma: Treatable Traits of a Heterogeneous Disease, by F.R. Bertuccio, F. Agustoni, G. Galli, et al (Cancers, 2023).

The study

• Authors: F.R. Bertuccio, F. Agustoni, G. Galli, C. Bortolotto, J. Saddi, G. Baietto, N. Baio, S. Montini, P. Putignano, G. D'Ambrosio, A.G. Corsico, P. Pedrazzoli, G.M. Stella
• Journal: Cancers
• Published: 2023;15(24)
• Type of article: Review
• Cited by: 2 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Pleural mesothelioma is an aggressive disease with diffuse nature, low median survival, and prolonged latency presenting difficulty in prognosis, diagnosis, and treatment. Here, we review all these aspects to underline the progress being made in its investigation and to emphasize how much work remains to be carried out to improve prognosis and treatment.

In plain English

This article was a narrative review of published research on pleural mesothelioma, a cancer of the lining of the chest cavity. It reported no new patient study or trial; one figure showed a single illustrative case. The authors summarized others' work on how common the disease is, how asbestos and other mineral fibers are thought to cause it, gene changes such as BAP1, diagnosis, staging and treatment. Among the work they described, Driscoll et al. estimated up to 43,000 deaths a year worldwide, and the World Health Organization was cited as linking the disease to all forms of asbestos exposure. The review reported that the MARS2 trial found no significant difference in survival between chemotherapy plus extended pleurectomy decortication surgery and chemotherapy without surgery. It also reported that first-line nivolumab plus ipilimumab gained FDA approval for advanced mesothelioma. It covered experimental approaches too, noting that PARP inhibitor trials gave largely negative survival results and that CAR T-cell therapy had been studied in phase I trials. The authors concluded that patients should be referred to specialized centers and evaluated by interdisciplinary teams.

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 (no search or selection methods described)
• Who was studied: No study population of its own. The authors reviewed published research on pleural mesothelioma (epidemiology, causes, genetics, diagnosis, staging, treatment). Figure 2 illustrates a single case of a pleural malignant lesion with imaging, thoracoscopic and biopsy findings.
• Exposure: Asbestos was discussed as the main cause. The article names six regulated minerals: chrysotile (a serpentine) and the amphiboles crocidolite, actinolite, tremolite, anthophyllite and amosite. Naturally occurring erionite fibers were also discussed.
• Main results:
  • The review cited an estimate by Driscoll et al. that up to 43,000 people per year die of the disease worldwide
  • The review cited the WHO as identifying pleural mesothelioma as directly linked to all forms of asbestos exposure
  • The review described cited studies that found germline BAP1 mutations in two unrelated US families with a high incidence of mesothelioma and no occupational asbestos exposure
  • The review reported that the MARS2 trial found no significant difference in survival between chemotherapy with extended pleurectomy decortication and chemotherapy without surgery
  • The review reported that, following the CheckMate743 study, first-line nivolumab plus ipilimumab was granted FDA approval for advanced mesothelioma
  • The review reported that trials of PARP inhibitors in mesothelioma gave largely negative progression-free and overall survival results
  • The review described CAR T-cell therapy against tumor antigens such as mesothelin as investigated in numerous phase I studies
• The authors' conclusion: The authors concluded that pleural mesothelioma patients should be referred to specialized centers and evaluated by interdisciplinary teams to choose a strategy tailored to the patient

Topics

Medical terms in this study, explained in our Lexicon: Pleural Mesothelioma, Median Overall Survival, Latency, Prognosis.

Related studies

• Malignant Pleural Mesothelioma: From Pathophysiology to Innovative Actionable Targets — F.R. Bertuccio, S. Montini, et al. (2025)
• Heterogeneous Contributing Factors in MPM Disease Development and Progression: Biological Advances and Clinical Implications — B. Tolani, L.A. Acevedo, et al. (2018)
• Phase I Clinical Trial on Pleural Mesothelioma Using Neoadjuvant Local Administration of Paclitaxel-Loaded Mesenchymal Stromal Cells (PACLIMES Trial): Study Rationale and Design — G.M. Stella, D. Lisini, et al. (2024)
• Early peritoneal mesothelioma: a treatable malignancy — K.H. Antman, R.T. Osteen, et al. (1985)
• Quality of life and personality traits in patients with malignant pleural mesothelioma and their first-degree caregivers — A. Granieri, S. Tamburello, et al. (2013)
• Inference of causal relationships between sleep-related traits and 1,527 phenotypes using genetic data — L.M. García-Marín, A.I. Campos, et al. (2021)

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