Rethought histologic classification of pleural mesothelioma to better treat: go forward from looking back

Our plain-English summary of Rethought histologic classification of pleural mesothelioma to better treat: go forward from looking back, by P. Astoul (Translational Lung Cancer Research, 2020).

The study

• Author: P. Astoul
• Journal: Translational Lung Cancer Research
• Published: 2020;9(4):1613-1616
• Type of article: Editorial, Comment
• Cited by: 3 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

In plain English

This is an editorial commentary, not a research study. Commissioned by the journal, it did not undergo external peer review. The author commented on proposals by a multidisciplinary EURACAN/IASLC group (Nicholson and colleagues, Journal of Thoracic Oncology 2020) for updating the histologic classification of malignant pleural mesothelioma, meaning how the tumor tissue is categorized under the microscope. The commentary reported no new patient data and did not discuss asbestos exposure. The author described the group's focus on localized mesothelioma, rare features within the epithelioid and sarcomatoid subtypes, mesothelioma in situ, and a grading system for epithelial mesothelioma. The author wrote that PD-L1 status, loss of BAP1 and CDKN2A deletion should be part of histologic reports. The author also wrote that blood-based biomarkers remain useless for diagnosis and prognosis, and that clinical practice has not changed: chemotherapy based on cisplatin and a third-generation cytotoxic agent, with or without bevacizumab, remains the standard option. The author concluded that standardized, adequate tissue sampling, ideally by thoracoscopy, is paramount because more targeted treatments are expected, summing this up as "the tissue is the issue".

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, commissioned by the journal, without external peer review; no original data
• Who was studied: No patients were studied; the article comments on the EURACAN/IASLC proposals for updating the histologic classification of pleural mesothelioma (Nicholson et al., J Thorac Oncol 2020)
• Main results:
  • The author described the EURACAN/IASLC group as multidisciplinary, including pathologists, molecular biologists and radiologists, as well as surgeons and oncologists
  • Among the group's focus areas, the author described mesothelioma in situ (MMIS) as a possible starting point for diffuse pleural mesothelioma
  • The author described the group's focus on routinely applying a pathologic grading system to pleural biopsies and resection specimens of epithelial mesothelioma, with a two-tier low/high grade system
  • The author's view was that PD-L1 status, loss of BAP1 and CDKN2A deletion should be part of histologic reports
  • The author wrote that blood-based biomarkers remain useless for diagnosis and prognosis of pleural mesothelioma
  • The author wrote that clinical practice has not changed and chemotherapy based on cisplatin and a third-generation cytotoxic agent, with or without bevacizumab, remains the standard option
• The authors' conclusion: The author concluded that standardized, adequate tissue sampling to diagnose and molecularly characterize pleural mesothelioma is paramount because more targeted treatments are expected, that biopsy samples (ideally by thoracoscopy) are necessary, and that 'the tissue is the issue'

Topics

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

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