Validity of the modified RECIST criteria and EORTC PET criteria evaluated based on the pathologic findings for patients with resectable malignant pleural mesothelioma

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e11639-e11639
Author(s):  
T. Mimura ◽  
H. Watanabe ◽  
T. Yamanaka ◽  
M. Satouchi ◽  
M. Okada
Keyword(s):  
Clinical Trials ◽  
Malignant Pleural Mesothelioma ◽  
Surrogate Endpoint ◽  
Kappa Statistics ◽  
Pleural Mesothelioma ◽  
European Organization ◽  
Pathologic Findings ◽  
Modified Recist ◽  
Definition Of ◽  
Measurable Lesion

e11639 Background: The unique growth pattern of malignant pleural mesothelioma (MPM) presents challenges for clinical investigators evaluating the responses to chemotherapy, which is an important surrogate endpoint for patient benefit, particularly in clinical trials. In patients with resectable MPM, multicenter clinical trials of neoadjuvant chemotherapy followed by extrapleral pneumonectomy (EPP) and subsequent radiotherapy have been attempted around the world. The applicability of modified RECIST based on the findings on CT images and EORTC (European Organization for Research and Treatment of Cancer) criteria based on the findings on FDG-PET images to resectable MPM would be challenging and significant, but their validity has never been examined. Methods: Between May 2006 and November 2008, 13 consecutive patients with resectable pathologically proven MPM were included in this study. All were initially treated with combination chemotherapy including cisplatin. EPP was successfully performed in all the patients. In addition to modified RECIST (CR vs PR vs SD vs PD), FDG uptake by the tumor on PET was also evaluated according to the EORTC PET criteria (CMR vs PMR vs SMD vs PMD). Also, pathologic findings (NT; no viable tumor vs MR; minimal residual vs GR; gross residual) were reviewed. Results: According to modified RECIST, in which the definition of measurable lesions is ≥10mm in diameter, 7 of the 13 patients investigated had no measurable lesion. Even when the definition of measurable lesions was changed to ≥5mm, 2 patients had no measurable lesion and 4 had only one lesion. In regard to the response, 4 of 11 patients with any measurable lesions were classified as PR, and 7 were classified as SD, while 8 patients were classified as PMR and 3 were classified as SMD according to the PET findings. Eight patients were classified as GR and 5 as MR. Kappa statistics suggested potential variation between the CT response and the pathologic findings (κ=0.214, 95% CI=-0.377 ∼ 0.806) and between the PET response and the pathologic findings (κ=0.286, 95% CI=-0.049 ∼ 0.620). Conclusions: Our data raise doubts about the validity of applying the modified RECIST criteria as well as EORTC PET criteria to resectable MPM. No significant financial relationships to disclose.

Prognostic factors in patients with pleural mesothelioma: the European Organization for Research and Treatment of Cancer experience.

1998 ◽  
Vol 16 (1) ◽  
pp. 145-152 ◽  
Author(s):  
D Curran ◽  
T Sahmoud ◽  
P Therasse ◽  
J van Meerbeeck ◽  
P E Postmus ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Prognostic Factors ◽  
Malignant Pleural Mesothelioma ◽  
Poor Prognosis ◽  
Survival Duration ◽  
Pleural Mesothelioma ◽  
European Organization ◽  
Histologic Subtype ◽  
Prognosis Group ◽  
Group 1

PURPOSE Identification of prognostic factors in patients with malignant pleural mesothelioma based on prospectively collected international data. PATIENTS AND METHODS From October 1984 to October 1993, 204 eligible adult patients with malignant pleural mesothelioma were entered into five consecutive prospective European Organization for Research and Treatment of Cancer (EORTC) phase II clinical trials designed to assess the efficacy of various anticancer drugs (mitoxantrone, epidoxorubicin, etoposide, and paclitaxel). The Cox model was used to assess 13 factors related to biology and disease history with respect to survival. RESULTS The median survival duration was 12.6 months from diagnosis and 8.4 months from trial entry. In the multivariate analysis, poor prognosis was associated with a poor performance status, a high WBC count, a probable/possible histologic diagnosis of mesothelioma, male gender, and having sarcomatous tissue as the histologic subtype. Taking these five factors into consideration, patients were classified into two groups: a good-prognosis group (1-year survival rate, 40%; 95% confidence interval [CI], 30% to 50%) and a poor-prognosis group (1-year survival, 12%; 95% CI, 4% to 20%). CONCLUSION These results may help to design new clinical trials in pleural mesothelioma by selecting more homogenous groups of patients.

scholarly journals The Evolving Landscape of the Molecular Epidemiology of Malignant Pleural Mesothelioma

2021 ◽  
Vol 10 (5) ◽  
pp. 1034
Author(s):  
Sara Lettieri ◽  
Chandra Bortolotto ◽  
Francesco Agustoni ◽  
Filippo Lococo ◽  
Andrea Lancia ◽  
...  
Keyword(s):  
Molecular Epidemiology ◽  
Malignant Pleural Mesothelioma ◽  
Strong Association ◽  
Pleural Mesothelioma ◽  
The European Union ◽  
Long Latency ◽  
Substantial Risk ◽  
Novel Biomarkers ◽  
Definition Of ◽  
Novel Concept

Malignant pleural mesothelioma (MPM) is a rare and aggressive malignancy that most commonly affects the pleural lining of the lungs. It has a strong association with exposure to biopersistent fibers, mainly asbestos (80% of cases) and—in specific geographic regions—erionite, zeolites, ophiolites, and fluoro-edenite. Individuals with a chronic exposure to asbestos generally have a long latency with no or few symptoms. Then, when patients do become symptomatic, they present with advanced disease and a worse overall survival (about 13/15 months). The fibers from industrial production not only pose a substantial risk to workers, but also to their relatives and to the surrounding community. Modern targeted therapies that have shown benefit in other human tumors have thus far failed in MPM. Overall, MPM has been listed as orphan disease by the European Union. However, molecular high-throughput profiling is currently unveiling novel biomarkers and actionable targets. We here discuss the natural evolution, mainly focusing on the novel concept of molecular epidemiology. The application of innovative endpoints, quantification of genetic damages, and definition of genetic susceptibility are reviewed, with the ultimate goal to point out new tools for screening of exposed subject and for designing more efficient diagnostic and therapeutic strategies.

scholarly journals Brief Report: A Phase II Study of Sunitinib in Malignant Pleural Mesothelioma. The NCIC Clinical Trials Group

2011 ◽  
Vol 6 (11) ◽  
pp. 1950-1954 ◽  
Author(s):  
Scott A. Laurie ◽  
Ashish Gupta ◽  
Quincy Chu ◽  
Christopher W. Lee ◽  
Wojciech Morzycki ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Phase Ii ◽  
Malignant Pleural Mesothelioma ◽  
Phase Ii Study ◽  
Pleural Mesothelioma

scholarly journals Optimal Definition of Target Volumes in Lung-Sparing Pleural Radiotherapy for Malignant Pleural Mesothelioma (Mpm)

2014 ◽  
Vol 25 ◽  
pp. iv543
Author(s):  
A. Botticella ◽  
G. Defraene ◽  
K. Nackaerts ◽  
C. Deroose ◽  
J. Coolen ◽  
...  
Keyword(s):  
Malignant Pleural Mesothelioma ◽  
Pleural Mesothelioma ◽  
Target Volumes ◽  
Definition Of

scholarly journals Early specialist palliative care on quality of life for malignant pleural mesothelioma: a randomised controlled trial

Thorax ◽  
2019 ◽  
Vol 74 (4) ◽  
pp. 354-361 ◽  
Author(s):  
Fraser Brims ◽  
Samal Gunatilake ◽  
Iain Lawrie ◽  
Laura Marshall ◽  
Carole Fogg ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Malignant Pleural Mesothelioma ◽  
Controlled Trial ◽  
Mean Difference ◽  
Pleural Mesothelioma ◽  
Life Questionnaire ◽  
Specialist Palliative Care ◽  
European Organization

PurposeMalignant pleural mesothelioma (MPM) has a high symptom burden and poor survival. Evidence from other cancer types suggests some benefit in health-related quality of life (HRQoL) with early specialist palliative care (SPC) integrated with oncological services, but the certainty of evidence is low.MethodsWe performed a multicentre, randomised, parallel group controlled trial comparing early referral to SPC versus standard care across 19 hospital sites in the UK and one large site in Western Australia. Participants had newly diagnosed MPM; main carers were additionally recruited. Intervention: review by SPC within 3 weeks of allocation and every 4 weeks throughout the study. HRQoL was assessed at baseline and every 4 weeks with the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire Core 30. Primary outcome: change in EORTC C30 Global Health Status 12 weeks after randomisation.ResultsBetween April 2014 and October 2016, 174 participants were randomised. There was no significant between group difference in HRQoL score at 12 weeks (mean difference 1.8 (95% CI −4.9 to 8.5; p=0.59)). HRQoL did not differ at 24 weeks (mean difference −2.0 (95% CI −8.6 to 4.6; p=0.54)). There was no difference in depression/anxiety scores at 12 weeks or 24 weeks. In carers, there was no difference in HRQoL or mood at 12 weeks or 24 weeks, although there was a consistent preference for care, favouring the intervention arm.ConclusionThere is no role for routine referral to SPC soon after diagnosis of MPM for patients who are cared for in centres with good access to SPC when required.Trial registration numberISRCTN18955704.

scholarly journals Clinical Trials for Unresectable Malignant Pleural Mesothelioma

Haigan ◽  
2009 ◽  
Vol 49 (4) ◽  
pp. 397-402
Author(s):  
Kazuya Fukuoka ◽  
Takashi Nakano
Keyword(s):  
Clinical Trials ◽  
Malignant Pleural Mesothelioma ◽  
Pleural Mesothelioma
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