bims-mesote 2024-09-01 papers

Curr Oncol. 2024 Jul 30. 31(8): 4318-4337

Rehabilitation for Functioning and Quality of Life in Patients with Malignant Pleural Mesothelioma: A Scoping Review.

Lorenzo Lippi, Alessandro de Sire, Vittorio Aprile, Dario Calafiore, Arianna Folli, Fjorelo Refati, Andrea Balduit, Alessandro Mangogna, Mariia Ivanova, Konstantinos Venetis, Nicola Fusco, Marco Invernizzi.

Malignant pleural mesothelioma (MPM) represents a significant clinical challenge due to limited therapeutic options and poor prognosis. Beyond mere survivorship, setting up an effective framework to improve functioning and quality of life is an urgent need in the comprehensive management of MPM patients. Therefore, this study aims to review the current understanding of MPM sequelae and the effectiveness of rehabilitative interventions in the holistic approach to MPM. A narrative review was conducted to summarize MPM sequelae and their impact on functioning, disability, and quality of life, focusing on rehabilitation interventions in MPM management and highlighting gaps in knowledge and areas for further investigation. Our findings showed that MPM patients experience debilitating symptoms, including fatigue, dyspnea, pain, and reduced exercise tolerance, decreasing quality of life. Supportive and rehabilitative interventions, including pulmonary rehabilitation, physical exercise improvement, psychological support, pain management, and nutritional supplementation, seem promising approaches in relieving symptoms and improving quality of life but require further research. These programs emphasize the pivotal synergy among patient-tailored plans, multidisciplinary team involvement, and disease-specific focus. Despite advancements in therapeutic management, MPM remains a challenging disease with limited effective interventions that should be adapted to disease progressions. Rehabilitative strategies are essential to mitigate symptoms and improve the quality of life in MPM patients. Further research is needed to establish evidence-based guidelines for rehabilitative interventions tailored to the unique needs of MPM patients.

Keywords: complementary treatment; malignant pleural mesothelioma; muscle; physical exercise; physical function; rehabilitation

DOI: https://doi.org/10.3390/curroncol31080322

J Thorac Oncol. 2024 Aug 24. pii: S1556-0864(24)00770-6. [Epub ahead of print]

Erratum to "Brief Report: Canadian Cancer Trials Group IND.227: A Phase II randomized study of pembrolizumab in patients with advanced malignant pleural mesothelioma (NCT02784171). [Journal of Thoracic Oncology Vol. 18 No. 6: 813-819]".

DOI: https://doi.org/10.1016/j.jtho.2024.08.017

Gan To Kagaku Ryoho. 2024 Aug;51(8): 802-805

[Ⅰ. Current Topics in Pleural Mesothelioma].

Masaki Hashimoto.

J Thorac Oncol. 2024 Aug 22. pii: S1556-0864(24)00777-9. [Epub ahead of print]

The IASLC Mesothelioma Staging Project: Proposals for the M Descriptors in the Forthcoming 9th Edition of the TNM Classification for Pleural Mesothelioma.

members of the IASLC Staging and Prognostic Factors Committee

INTRODUCTION: The International Association for the Study of Lung Cancer (IASLC) developed a global multicenter database to propose evidence-based revisions for the 9th edition of the Tumor Node Metastasis (TNM) classification of pleural mesothelioma (PM). This study analyses the M category to validate 8th edition M category recommendations.METHODS: Cases were submitted electronically or by transfer of existing institutional databases for patients with histologically or cytologically confirmed PM. The presence and number of metastases (single versus multiple) in each of eight organ systems were reported for patients with M1 disease at diagnosis. Overall survival (OS) was calculated by the Kaplan-Meier method. Differences in OS were assessed by log-rank test.
RESULTS: Of 7,338 submitted cases, 3,598 were eligible 3,221 had sufficient data for clinical staging; 228 cases (7%) were M1. Median overall estimated survival was inferior for M1 compared with M0 patients: 10.5 versus 21.5 months, respectively (p<0.0001); estimated one-year survival was 46% versus 71%. OS differences between M categories were preserved within histologic subgroups. Among 158 patients with organ-specific documentation of M1 disease, there was no statistically significant difference in OS between those with intrathoracic versus more distant metastatic disease (14.4 months versus 10.9 months, p=0.64). No significant survival difference was detected between patients with metastatic disease in a single organ system versus multiple organ systems (12.6 versus 8.8 months, p=0.45).
CONCLUSION: This evidence-based analysis of the M category for PM conforms with the 8th edition M-descriptors. No changes are proposed in the 9th edition of the mesothelioma M category.

Keywords: M component; Mesothelioma; Staging

DOI: https://doi.org/10.1016/j.jtho.2024.08.022

Med Lav. 2024 Aug 27. 115(4): e2024028

Trends in Asbestos Exposure and Malignant Mesothelioma Incidence in Emilia-Romagna Italy: A Retrospective Study 1996-2023.

Fausto Giacomino, Francesco Marinelli, Isabella Bisceglia, Marco Cacchi, Cinzia Storchi, Carmine Pinto, Lucia Mangone, Antonio Romanelli, Fortunato Morabito.

Malignant mesothelioma (MM) is a rare but lethal cancer strongly associated with asbestos exposure. This retrospective study examines trends in asbestos exposure in Emilia-Romagna, Northern Italy. Between 1996 and 2023, 3,513 cases of MM were recorded, predominantly in males (72%) and in older than 65 years (79%). Occupational exposure accounted for 82% of cases, with a significant increase observed over time from 71% to 88% in the most recent period. A greater definition of professional exposure indicates that certain exposure has gone from 49% in the first period to 62% and 58% in the last two periods; probable exposure showed a decrease from 21% to 16% while possible exposure decreased from 16% to 13%. Familiar exposure remained relatively constant at around 8%, environmental exposure showed a slight decrease from 4% to 2%, while non-occupational exposure remained stable at 2%. Among patients with exclusively occupational exposure (1,826 cases), 87% were male and aged between 65 and 75 years (36%) and 75+ (41%). The exposure rates for the province of residence see the province of Reggio Emilia with the highest occupational exposure rate (2.5 x 100,000 residents), followed by Ravenna (2.3 x 100,000 residents) and Parma and Piacenza which have similar exposure rates with 2.2 x 100,000 residents. Professional sectors such as construction, railway maintenance and metalworking are identified as high-risk industries. Despite efforts to mitigate exposure, non-occupational and environmental exposures persist. The study highlights the importance of continuous surveillance and exposure monitoring to guide effective interventions and legal recognition of MM.

DOI: https://doi.org/10.23749/mdl.v115i4.16005

Lung Cancer. 2024 Aug 13. pii: S0169-5002(24)00462-8. [Epub ahead of print]195 107928

Randomized trial of anetumab ravtansine and pembrolizumab compared to pembrolizumab for mesothelioma.

PURPOSE: The mesothelin-targeting antibody-drug conjugate anetumab ravtansine was evaluated in combination with the programmed cell death-1 (PD-1) inhibitor pembrolizumab based on the common expression of mesothelin and reports of activity in mesothelioma.PATIENTS AND METHODS: A phase 1 safety run-in of the combination of anetumab ravtansine (6.5 mg/kg iv q3weeks) and pembrolizumab (200 mg, IV q3weeks) was conducted, followed by a phase 2 randomization to the combination or pembrolizumab alone at medical centers across the United States and Canada in the National Cancer Institute's Experimental Therapeutics Clinical Trials Network. Patients with pleural mesothelioma that expressed mesothelin and had previously received platinum-based therapy were eligible.
RESULTS: In phase 1 (n = 12) only one dose limiting toxicity was observed and the rules for dose reduction were not met. In phase 2, there was no difference in the confirmed response rates between the combination group (n = 18, 2 partial responses [PR], 11 %) and the pembrolizumab group (n = 17, 1 PR, 6 %; z = -0.5523, p = 0.29116). The median PFS was 12.2 months (95 % CI 5.1-not evaluable [NE]) for the combination, and 3.9 months for pembrolizumab (95 % CI 2.1-NE)(HR=0.55, p = 0.20). Patients with high baseline levels of soluble mesothelin who received anetumab ravtansine had a median PFS of 5 months.
CONCLUSIONS: The numeric difference in PFS between treatment groups was not statistically significant, likely related to a smaller than planned sample size. High levels of soluble mesothelin should potentially be considered to select against the use of mesothelin-targeting therapies in development that are neutralized by soluble mesothelin.

Keywords: Antibody-drug conjugate; Immune checkpoint inhibitor; Mesothelin; Mesothelioma; PD-1

DOI: https://doi.org/10.1016/j.lungcan.2024.107928