OA04.02 Diaphragm and Phrenic Nerve Preservation During Lung-Sparing Surgery for Malignant Pleural Mesothelioma: The Impact on Patient Outcomes

2021 ◽  
Vol 16 (10) ◽  
pp. S853
Author(s):  
M. Culligan ◽  
S. Ho ◽  
V. Marchese ◽  
O. Goloubeva ◽  
J. Friedberg
Keyword(s):  
Patient Outcomes ◽  
Malignant Pleural Mesothelioma ◽  
Phrenic Nerve ◽  
Pleural Mesothelioma ◽  
Nerve Preservation ◽  
The Impact

A randomized phase II trial of oral vinorelbine as second-line therapy for patients with malignant pleural mesothelioma.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 8507-8507
Author(s):  
Dean Anthony Fennell ◽  
Angela Claire Casbard ◽  
Catharine Porter ◽  
Robin Rudd ◽  
Jason Francis Lester ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Treatment Option ◽  
Malignant Pleural Mesothelioma ◽  
Hazard Ratio ◽  
Clinical Activity ◽  
Pleural Mesothelioma ◽  
Off Label Use ◽  
Off Label ◽  
The Impact ◽  
Label Use

8507 Background: All patients with malignant pleural mesothelioma (MPM) eventually relapse following standard chemotherapy. However, there is no standard treatment option in this setting. Vinorelbine, exhibits useful clinical activity but has not been formally evaluated in a randomised clinical trial, despite its widespread off-label use worldwide. BRCA1 regulates spindle assembly checkpoint in MPM and predicts vinorelbine sensitivity in preclinical models [1,2], suggesting that BRCA1 negative patients may be chemoresistant. Methods: VIM, a Cancer Research UK funded, investigator-initiated randomised controlled phase 2 multi-centre UK trial, enrolled patients with MPM who had progressed after first-line chemotherapy. Pts were randomised 2:1 to either vinorelbine (60mg/m2 weekly Q21d escalating to 80mg/m2 from cycle 2) + active supportive care (ASC) versus ASC until disease progression, unacceptable toxicity or withdrawal of consent. The primary outcome was progression free survival (PFS) defined as the time from randomisation to any progression (based on Modified RECIST criteria for assessment of response in malignant pleural mesothelioma) or death. The trial had 90% power to detect a hazard ratio of 0.65 at the one-sided 20% significance level. Secondary endpoints were overall survival (OS), tolerability and safety. Results: Between May 2016 and Oct 2018, 154 patients were recruited from 10 UK sites and randomised to vinorelbine + ASC (n=98) or ASC alone (n=56). In the Intention-to-treat analysis, after 129 events, median PFS was 4.2 months (m) for vinorelbine + ASC compared to 2.8m for ASC alone (Hazard Ratio (HR) 0.59; 95% CI: 0.41 to 0.85; one-sided p = 0.0017). 108 deaths were reported. Median OS was 9.3m for vinorelbine + ASC compared to 9.1m for ASC alone (HR=0.79; 95% CI: 0.53 to 1.17; two-sided p = 0.24). Toxicity data and subgroup analyses including the impact of BRCA1 deficiency will be presented. Conclusion: The trial met its primary endpoint. Vinorelbine demonstrates useful clinical efficacy in relapsed MPM, supporting its off-label use, as a treatment option for patients with relapsed MPM.[1] Busacca et al, J Pathol 2012, 227(2), 200. [2] Busacca et al, Mol Cancer Res, 2021, 20(2) 379. Clinical trial information: NCT02139904.

The Impact of Adjuvant Hemithoracic Radiation on Outcomes in Patients with Stage I-III Malignant Pleural Mesothelioma

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Vignesh Raman ◽  
Soraya L. Voigt ◽  
Oliver K. Jawitz ◽  
Norma E. Farrow ◽  
Kristen E. Rhodin ◽  
...  
Keyword(s):  
Malignant Pleural Mesothelioma ◽  
Stage I ◽  
Pleural Mesothelioma ◽  
The Impact

scholarly journals miR-182 facilitates invasion and EMT by targeting Numb in Malignant Pleural Mesothelioma

2020 ◽  
Author(s):  
Yanmeng Kang ◽  
Degan Lu ◽  
Lingxia Meng ◽  
Ruiping Ma ◽  
Chuanjun Huang ◽  
...  
Keyword(s):  
Malignant Pleural Mesothelioma ◽  
Luciferase Reporter ◽  
Pleural Mesothelioma ◽  
Reporter Plasmid ◽  
Luciferase Reporter Plasmid ◽  
Aggressive Tumor ◽  
High Level ◽  
The Impact ◽  
Test Correlation

Abstract Background Malignant Pleural Mesothelioma (MPM) is a highly aggressive tumor which need effective therapeutic methods to improve the prognosis. We carried out this study to explore the role of miR-182 in MPM development, its correlation with Numb expression and EMT. Methods First, we investigated the level of miR-182 and Numb-mRNA by qRT-PCR. Furthermore, we introduced the putative miR-182 binding site into a luciferase reporter plasmid to illustrate the impact of miR-182 on Numb. Then, we down-regulated the expression of miR-182 with/without Numb knocked down in NCI-H2452 cells to investigated their effect. Data were presented as mean ± SD of three independent experiments. Student’s test, correlation analysis and analysis of variance (ANOVA) were used. Results Our results revealed that miR-182 has a high level of expression in MPM, it has a negative correlation with Numb and targeted Numb in MPM cells. miR-182 facilitated the invasion of MPM cells while down-regulation of miR-182 restrained the progression of EMT and made MPM cells more susceptible to pemetrexed. Conclusions miR-182 and Numb can serve as potential therapeutic targets for MPM.

O-075 Malignant pleural mesothelioma (MPM): New predictors ofsurvival and an analysis of the impact of current treatment

Lung Cancer ◽  
2005 ◽  
Vol 49 ◽  
pp. S28 ◽  
Author(s):  
R. Flores ◽  
M. Zakowski ◽  
E. Venkatramen ◽  
L. Krug ◽  
K. Rosenzweig ◽  
...  
Keyword(s):  
Malignant Pleural Mesothelioma ◽  
Current Treatment ◽  
Pleural Mesothelioma ◽  
The Impact

Prognostic factors in malignant pleural mesothelioma (MPM): A mono-institutional evaluation of Bologna Malignant Pleural Mesothelioma Group.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e18509-e18509
Author(s):  
Daniela Adua ◽  
Francesca Sperandi ◽  
Paolo Castellucci ◽  
Barbara Melotti ◽  
Stefania Giaquinta ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Prognostic Factor ◽  
Malignant Pleural Mesothelioma ◽  
Cox Regression ◽  
Statistical Significance ◽  
Multimodality Treatment ◽  
Extrapleural Pneumonectomy ◽  
Pleural Mesothelioma ◽  
Histological Subtype ◽  
The Impact

e18509 Background: The prognostic systems currently in use in MPM, such as the EORTC and CALGB score, include the clinical and histological parameters, excluding the FDG-PET (PET) evaluation and the possibility of surgery. The aim of our study was to investigate the role of PET baseline SUV-max and surgery as prognostic factors in MPM. Methods: From April 2002to December 2012, 48 pts with a certain histological diagnosis of MPM underwent staging by PET scan before peri-operative (multimodality treatment) or palliative first-line chemotherapy (CT). Surgery was performed in 22(45.8%) pts. Pt characteristics: males 44(91.7%), females 4(8.3%); median age 65 (51-77) years; ECOG PS 0-1 45(93.7 %), PS 2 3(6.3 %); IMIG stage I-II 18(37.5%), III-IV 30(62.5%); histological subtype epithelial 40(83.3%), mixed 5(10.4%), sarcomatoid 3(6.3%); extrapleural pneumonectomy 8(16.8%), pleurectomy/decortication 14(29.2%), 17 (35.4%) VATS plus pleurodesis, 19(39.6%) no surgical procedures. Platinum based CT was performed in combination with pemetrexed in 39(81.3%) pts and with gemcitabine in 9(18.7%). According to the EORTC score 30(62.5%) pts were classified in the good prognosis group and 18(37.5%) as poor prognosis. The cut-off value of PET baseline SUV-max calculated by ROC analysis was 9; SUV-max at baseline PET was ≤ 9 in 32(66.7%) pts and >9 in 16(33.3%). Median overall survival (OS) was 12 (3-60) months. Results: Upon validating the impact of individual factors on OS using the Kaplan-Meier analysis, we found statistical significance was reached by histology (p=0.0038) and surgery (p=0.0027). In a multivariate analysis using the Cox regression system, considering OS as a dependent variable, according to age, histology, stage, PET baseline SUV-max and surgery, epithelial histology (p =0.002) and surgery (p=0.012) achieved a statistical significance. SUV-max at baseline PET was not statistically significant (p = 0.290), excluding it as a possible independent prognostic factor in MPM. Conclusions: This analysis does not indicate any prognostic value for baseline PET in MPM, confirming the importance of histological subtype and introducing surgery as a possible prognostic factor.

scholarly journals Impact of tumour thickness on survival after radical radiation and surgery in malignant pleural mesothelioma

2017 ◽  
Vol 49 (3) ◽  
pp. 1601428 ◽  
Author(s):  
Marc de Perrot ◽  
Zhi Dong ◽  
Penelope Bradbury ◽  
Demetris Patsios ◽  
Shaf Keshavjee ◽  
...  
Keyword(s):  
Malignant Pleural Mesothelioma ◽  
Disease Free Survival ◽  
Clinical Staging ◽  
Pleural Mesothelioma ◽  
Histologic Subtype ◽  
Free Survival ◽  
Tumour Thickness ◽  
Selection For ◽  
The Impact ◽  
Disease Free

Tumour thickness was assessed to determine if this parameter could refine patients' selection for multimodality therapy in malignant pleural mesothelioma.We reviewed 65 consecutive treatment-naïve malignant pleural mesothelioma patients undergoing surgery for mesothelioma after radiation therapy (SMART). Total tumour thickness was determined by measuring the maximal thickness on nine predefined sectors on the chest wall, mediastinum and diaphragm.After a median follow-up of 19 months, 40 patients (62%) developed recurrence and 36 died (55%). Total tumour thickness, ranging between 2.4 and 21 cm (median 6.9 cm), correlated with tumour volume (p<0.0001, R2=0.29) and maximum standardised uptake value (p=0.006, R2=0.11). Total tumour thickness had a significant impact on overall survival and disease-free survival in univariate analysis. In multivariate analysis, total tumour thickness remained an independent predictor of survival (p=0.02, hazard ratio (HR) 1.12, 95% CI 1.02–1.23) and disease-free survival (p=0.01, HR 1.13, 95% CI 1.03–1.24) along with epithelial histologic subtype (p<0.0001, HR 0.25, 95% CI 0.13–0.50) and pN2 disease (p=0.03, HR 2.15, 95% CI 1.07–4.33). Diaphragmatic tumour thickness correlated best with time to recurrence (p=0.002, R2=0.22) and time to death (p=0.003, R2=0.2).The impact of tumour thickness on survival and disease-free survival independent of histologic subtypes and nodal disease is extremely encouraging. This parameter could potentially be used to refine the clinical staging of malignant pleural mesothelioma and optimise patient selection for radical treatment.

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