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Liu YT, Wu HL, Su YD, Wang Y, Li Y. Development in the Study of Natural Killer Cells for Malignant Peritoneal Mesothelioma Treatment. Cancer Biother Radiopharm 2024. [PMID: 39093850 DOI: 10.1089/cbr.2024.0078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/04/2024] Open
Abstract
Malignant peritoneal mesothelioma (MPeM) is a rare primary malignant tumor originating from peritoneal mesothelial cells. Insufficient specificity of the symptoms and their frequent reappearance following surgery make it challenging to diagnose, creating a need for more efficient treatment options. Natural killer cells (NK cells) are part of the innate immune system and are classified as lymphoid cells. Under the regulation of activating and inhibiting receptors, NK cells secrete various cytokines to exert cytotoxic effects and participate in antiforeign body, antiviral, and antitumor activities. This review provides a comprehensive summary of the specific alterations observed in NK cells following MPeM treatment, including changes in cell number, subpopulation distribution, active receptors, and cytotoxicity. In addition, we summarize the impact of various therapeutic interventions, such as chemotherapy, immunotherapy, and targeted therapy, on NK cell function post-MPeM treatment.
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Affiliation(s)
- Yi-Tong Liu
- Department of Peritoneal Cancer Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| | - He-Liang Wu
- Department of Peritoneal Cancer Surgery, Beijing Shijitan Hospital, Peking University Ninth School of Clinical Medicine, Beijing, China
| | - Yan-Dong Su
- Department of Peritoneal Cancer Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| | - Yi Wang
- Department of Hematology, Fifth Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Yan Li
- Department of Peritoneal Cancer Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
- Department of Surgical Oncology, Beijing Tsinghua Changgung Hospital, Tsinghua University, Beijing, China
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2
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Zandwijk NV, Frank AL, Reid G, Dimitri Røe O, Amos CI. Asbestos-Related lung Cancer: An underappreciated oncological issue. Lung Cancer 2024; 194:107861. [PMID: 39003938 DOI: 10.1016/j.lungcan.2024.107861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 06/19/2024] [Accepted: 06/22/2024] [Indexed: 07/16/2024]
Abstract
Asbestos, a group of class I (WHO) carcinogenic fibers, is the main cause of mesothelioma. Asbestos inhalation also increases the risk to develop other solid tumours with lung cancer as the most prominent example [91]. The incidence of asbestos-related lung cancer (ARLC) is estimated to be to six times larger than the mesothelioma incidence thereby becoming an important health issue [86]. Although the pivotal role of asbestos in inducing lung cancer is well established, the precise causal relationships between exposures to asbestos, tobacco smoke, radon and 'particulate' (PM2.5) air pollution remain obscure and new knowledge is needed to establish appropriate preventive measures and to tailor existing screening practices[22,61,65]. We hypothesize that a part of the increasing numbers of lung cancer diagnoses in never-smokers can be explained by (historic and current) exposures to asbestos as well as combinations of different forms of air pollution (PM2.5, asbestos and silica).
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Affiliation(s)
- Nico van Zandwijk
- Sydney Local Health District (SLHD), Department of Cell and Molecular Therapies, Royal, Prince Alfred Hospital, Camperdown, NSW 2050, Australia; Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2050, Australia.
| | - Arthur L Frank
- School of Public Health of Drexel, University, Philadelphia, PA, USA
| | - Glen Reid
- Department of Pathology, Otago Medical, School, University of Otago, Dunedin, New Zealand
| | - Oluf Dimitri Røe
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
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3
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Gogou E, Hatzoglou C, Siachpazidou D, Zarogiannis SG, Gourgoulianis KI. Asbestos ban policies and mesothelioma mortality in Greece. BMC Public Health 2024; 24:1177. [PMID: 38671450 PMCID: PMC11055379 DOI: 10.1186/s12889-024-18030-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 02/07/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Malignant mesothelioma is a rare form of cancer that mostly affects the pleura and has a strong link to asbestos exposure. Greece banned the use of asbestos in 2005, however, the public was already aware of this substance in the 1980s. This research aims to present an overview of Greece's mesothelioma age-standardized mortality rates (ASMR) from 1983 to 2019 by age, gender, and geographic region and to determine whether the actions to ban asbestos impacted these rates. METHODS Data were retrieved by the Hellenic Statistical Authority (HSA) from death certificates that mentioned mesothelioma as the cause of death from 1983 to 2019 with details on the residence, gender, and age. Statistical analysis was performed using PRISM 6.0 software, a two-way ANOVA test, Trend analysis was conducted using Joinpoint Regression Program 5.0 software. The linear and non-linear model was used to calculate the age-standardized rates of annual percentage change (APC) and its 95% confidential interval (95% CI). RESULTS From 1983 to 2019, 850 total mesothelioma deaths were recorded, the majority of whom were males (634). A rate of 74.6% accounts for males and 25.4% for females, and the ratio of Males: Females was 3:1. Males' ASMR and the whole population's ASMR reached their highest levels in 2011 (0.93/100000person-years and 0.53/100000person-years, respectively). To look for potential changes between the first two decades of the 21st century, we compared the mean ASMR of each geographic region in Greece between two different 10-year subperiods (2000-2009 and 2010-2019). Except for Epirus, all regions of Greece had elevated regional ASMRs, particularly in those with the highest asbestos deposits. Notably, the ASMR in Epirus decreased from 0.54/100000person-years (2000-2009) to 0.31/100000person-years (2010-2019). After 2011, the ASMR for men and the general population stabilized. This stability is important since mesothelioma in men is associated with occupational asbestos exposure. The intriguing discovery of a lower ASMR in Epirus emphasizes the need to raise awareness of the condition and implement effective public health measures. CONCLUSIONS In Greece, the annual ASMR for males and the whole population reached its highest level in 2011, which is positive and encouraging and may be a sign that the rate will stabilize during the following years. Moreover, this study showed that the actions made in the 1980s regarding public awareness and surveillance directly impacted the decrease in Epirus rates. Future research, continual awareness, information, and recording are needed to monitor the mesothelioma epidemic. The possible benefit of a mesothelioma registry and the epidemiological surveillance of asbestos-related diseases, particularly mesothelioma mortality, need to be addressed. TRIAL REGISTRATION Not applicable.
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Affiliation(s)
- Evdoxia Gogou
- Department of Physiology, Faculty of Medicine, School of Health Sciences, University of Thessaly, BIOPOLIS, 41500, Larissa, Greece.
| | - Chryssi Hatzoglou
- Department of Physiology, Faculty of Medicine, School of Health Sciences, University of Thessaly, BIOPOLIS, 41500, Larissa, Greece
| | - Dimitra Siachpazidou
- Department of Respiratory Medicine, Faculty of Medicine, School of Health Sciences, University of Thessaly, BIOPOLIS, 41110, Larissa, Greece
| | - Sotirios G Zarogiannis
- Department of Physiology, Faculty of Medicine, School of Health Sciences, University of Thessaly, BIOPOLIS, 41500, Larissa, Greece
| | - Konstantinos I Gourgoulianis
- Department of Respiratory Medicine, Faculty of Medicine, School of Health Sciences, University of Thessaly, BIOPOLIS, 41110, Larissa, Greece
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4
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Łuniewski S, Rogowska W, Łozowicka B, Iwaniuk P. Plants, Microorganisms and Their Metabolites in Supporting Asbestos Detoxification-A Biological Perspective in Asbestos Treatment. MATERIALS (BASEL, SWITZERLAND) 2024; 17:1644. [PMID: 38612157 PMCID: PMC11012542 DOI: 10.3390/ma17071644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Revised: 02/13/2024] [Accepted: 03/26/2024] [Indexed: 04/14/2024]
Abstract
Many countries banned asbestos due to its toxicity, but considering its colossal use, especially in the 1960s and 1970s, disposing of waste containing asbestos is the current problem. Today, many asbestos disposal technologies are known, but they usually involve colossal investment and operating expenses, and the end- and by-products of these methods negatively impact the environment. This paper identifies a unique modern direction in detoxifying asbestos minerals, which involves using microorganisms and plants and their metabolites. The work comprehensively focuses on the interactions between asbestos and plants, bacteria and fungi, including lichens and, for the first time, yeast. Biological treatment is a prospect for in situ land reclamation and under industrial conditions, which can be a viable alternative to landfilling and an environmentally friendly substitute or supplement to thermal, mechanical, and chemical methods, often characterized by high cost intensity. Plant and microbial metabolism products are part of the green chemistry trend, a central strategic pillar of global industrial and environmental development.
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Affiliation(s)
- Stanisław Łuniewski
- Faculty of Economics, L.N. Gumilyov Eurasian National University, Satpayev 2, Astana 010008, Kazakhstan; (S.Ł.); (B.Ł.)
- Faculty of Economic Sciences, The Eastern European University of Applied Sciences in Bialystok, Ciepła 40 St., 15-472 Białystok, Poland
| | - Weronika Rogowska
- Department of Environmental Engineering Technology and Systems, Faculty of Civil Engineering and Environmental Sciences, Białystok University of Technology, Wiejska 45E St., 15-351 Białystok, Poland
- Institute of Plant Protection—National Research Institute, Chełmońskiego 22 St., 15-195 Białystok, Poland;
| | - Bożena Łozowicka
- Faculty of Economics, L.N. Gumilyov Eurasian National University, Satpayev 2, Astana 010008, Kazakhstan; (S.Ł.); (B.Ł.)
- Institute of Plant Protection—National Research Institute, Chełmońskiego 22 St., 15-195 Białystok, Poland;
| | - Piotr Iwaniuk
- Institute of Plant Protection—National Research Institute, Chełmońskiego 22 St., 15-195 Białystok, Poland;
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Ou Z, Li X, Cui J, Zhu S, Feng K, Ma J, Wu K, Chen Y, Su Y, Tang S, Duan D, Ren Y, Zhang X, Liang J, Wang Z. Global, regional, and national burden of asbestosis from 1990 to 2019 and the implications for prevention and control. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 904:166346. [PMID: 37591378 DOI: 10.1016/j.scitotenv.2023.166346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 08/11/2023] [Accepted: 08/14/2023] [Indexed: 08/19/2023]
Abstract
BACKGROUND Asbestosis is a common pneumoconiosis caused by long-term asbestos exposure. Analysis of the burden of asbestosis would help in creating informed public health strategies. METHODS Data on asbestosis were analyzed using the Global Burden of Disease study 2019. The estimated annual percentage change (EAPC) was calculated to demonstrate temporal trends in the age-standardized rate (ASR) of asbestosis from 1990 to 2019. RESULTS Globally, 36,339 incident cases of asbestosis, led to 3572 deaths and 71,225 disability adjusted life years (DALYs) in 2019. During 1990-2019, the overall ASRs of incidence and DALYs declined by an annual average of 0.29 % and 0.27 %, with the respective EAPCs being -0.29 (95 % confidence interval [CI]: -0.43, -0.14) and -0.27 (95%CI: -0.53, -0.01). The ASRs of mortality increased with EAPC of 0.65 (95%CI: 0.34, 0.96). Trends in incidence and prevalence rose in females, but declined in males. The asbestosis burden was heterogeneous across regions and countries. The heaviest burden of asbestosis was observed in the United States, India, and China. Trends in ASRs of asbestosis varied across countries/territories. Pronounced increasing trends in incidence and prevalence occurred in Georgia, Iran, and Croatia. CONCLUSIONS Decreasing incident trend of asbestosis was observed globally over the past three decades. However, the ongoing asbestosis burden highlighted that asbestosis remained a challenge to public health, and cost-effective measures were required to reduce the asbestosis burden.
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Affiliation(s)
- Zejin Ou
- Key Laboratory of Occupational Environment and Health, Guangzhou Twelfth People's Hospital, Guangzhou, China
| | - Xin Li
- School of Basic Medicine and Public Health, Jinan University, Guangzhou, China
| | - Jiaxin Cui
- School of Public Health, Sun Yat-Sen University, Guangzhou, China
| | - Shaofang Zhu
- Key Laboratory of Occupational Environment and Health, Guangzhou Twelfth People's Hospital, Guangzhou, China
| | - Kexin Feng
- Key Laboratory of Occupational Environment and Health, Guangzhou Twelfth People's Hospital, Guangzhou, China
| | - Jialao Ma
- School of Public Health, Guangzhou Medical University, Guangzhou, China
| | - Kangyong Wu
- School of Public Health, Guangzhou Medical University, Guangzhou, China
| | - Yuquan Chen
- Key Laboratory of Occupational Environment and Health, Guangzhou Twelfth People's Hospital, Guangzhou, China
| | - Yiwei Su
- Key Laboratory of Occupational Environment and Health, Guangzhou Twelfth People's Hospital, Guangzhou, China
| | - Shihao Tang
- Key Laboratory of Occupational Environment and Health, Guangzhou Twelfth People's Hospital, Guangzhou, China
| | - Danping Duan
- Key Laboratory of Occupational Environment and Health, Guangzhou Twelfth People's Hospital, Guangzhou, China
| | - Yixian Ren
- Key Laboratory of Occupational Environment and Health, Guangzhou Twelfth People's Hospital, Guangzhou, China
| | - Xing Zhang
- Institute of Occupational Diseases, Hangzhou Medical College (Zhejiang Academy of Medical Sciences), Hangzhou, China
| | - Jiabin Liang
- Key Laboratory of Occupational Environment and Health, Guangzhou Twelfth People's Hospital, Guangzhou, China
| | - Zhi Wang
- Key Laboratory of Occupational Environment and Health, Guangzhou Twelfth People's Hospital, Guangzhou, China.
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Stockhammer P, Baumeister H, Ploenes T, Bonella F, Theegarten D, Dome B, Pirker C, Berger W, Hegedüs L, Baranyi M, Schuler M, Deshayes S, Bölükbas S, Aigner C, Blanquart C, Hegedüs B. Krebs von den Lungen 6 (KL-6) is a novel diagnostic and prognostic biomarker in pleural mesothelioma. Lung Cancer 2023; 185:107360. [PMID: 37713954 DOI: 10.1016/j.lungcan.2023.107360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Revised: 08/26/2023] [Accepted: 09/04/2023] [Indexed: 09/17/2023]
Abstract
OBJECTIVES Pleural mesothelioma (PM) is a rare disease with dismal outcome. Systemic treatment options include chemotherapy and immunotherapy, but biomarkers for treatment personalization are missing. The only FDA-approved diagnostic biomarker is the soluble mesothelin-related protein (SMRP). Krebs von den Lungen-6 (KL-6) is a human mucin 1 (MUC1) glycoprotein, which has shown diagnostic and prognostic value as a biomarker in other malignancies. The present study investigated whether KL-6 can serve as a diagnostic and/or prognostic biomarker in PM. MATERIALS AND METHODS Using a fully-automated chemiluminescence enzyme immunoassay (CLEIA) for KL-6 and SMRP, pleural effusion samples from 87 consecutive patients with PM and 25 patients with non-malignant pleural disorders were studied. In addition, KL-6 and SMRP levels were determined in corresponding patient sera, and in an independent validation cohort (n = 122). MUC1 mRNA and protein expression, and KL-6 levels in cell line supernatants were investigated in PM primary cell lines in vitro. RESULTS PM patients had significantly higher KL-6 levels in pleural effusion than non-malignant controls (AUC 0.78, p < 0.0001). Among PM patients, levels were highest in those with epithelioid or biphasic histologies. There was a strong positive correlation between pleural effusion levels of KL-6 and SMRP (p < 0.0001). KL-6 levels in sera similarly associated with diagnosis of PM, however, to a lesser extent (AUC 0.71, p = 0.008). PM patients with high pleural effusion KL-6 levels (≥303 IU/mL) had significantly better overall survival (OS) compared to those with low KL-6 levels (HR 0.51, p = 0.004). Congruently, high tumor cell MUC1 mRNA expression in primary cell lines associated with prolonged corresponding patient OS (HR 0.35, p = 0.004). These findings were confirmed in an independent validation cohort. CONCLUSION This is the first study demonstrating KL-6 as a potential novel liquid-based diagnostic and prognostic biomarker in PM.
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Affiliation(s)
- Paul Stockhammer
- Department of Thoracic Surgery, Ruhrlandklinik, West German Cancer Center, University Duisburg-Essen, Tueschener Weg 40, 45239 Essen, Germany; Yale School of Medicine, Yale University, 333 Cedar St, New Haven, CT 06510, USA
| | - Hannah Baumeister
- Department of Thoracic Surgery, Ruhrlandklinik, West German Cancer Center, University Duisburg-Essen, Tueschener Weg 40, 45239 Essen, Germany
| | - Till Ploenes
- Department of Thoracic Surgery, Ruhrlandklinik, West German Cancer Center, University Duisburg-Essen, Tueschener Weg 40, 45239 Essen, Germany; Division of Thoracic Surgery, Department for Visceral-, Thoracic and Vascular Surgery, Medical Faculty Carl Gustav Carus and University Hospital, Technische Universität Dresden, Helmholtzstr. 10, 01069 Dresden, Germany
| | - Francesco Bonella
- Center for Interstitial and Rare Lung Disease Unit, Ruhrlandklinik University Hospital, University of Duisburg-Essen, Tueschener Weg 40, 45239 Essen, Germany
| | - Dirk Theegarten
- Institute of Pathology, University Hospital Essen, University Duisburg-Essen, Hufelandstraße 55, 45147 Essen, Germany
| | - Balazs Dome
- Department of Thoracic Surgery, Comprehensive Cancer Center, Medical University of Vienna, Spitalgasse 23, 1090 Vienna, Austria; Department of Thoracic Surgery, Semmelweis University and National Institute of Oncology, Ráth György u. 7-9, 1122 Budapest, Hungary; National Korányi Institute of Pulmonology, Korányi Frigyes út 1, 1122 Budapest, Hungary; Department of Translational Medicine, Lund University, Box 117, 221 00 Lund, Sweden
| | - Christine Pirker
- Center for Cancer Research and Comprehensive Cancer Center, Department of Medicine I, Medical University Vienna, Spitalgasse 23, 1090 Vienna, Austria
| | - Walter Berger
- Center for Cancer Research and Comprehensive Cancer Center, Department of Medicine I, Medical University Vienna, Spitalgasse 23, 1090 Vienna, Austria
| | - Luca Hegedüs
- Department of Thoracic Surgery, Ruhrlandklinik, West German Cancer Center, University Duisburg-Essen, Tueschener Weg 40, 45239 Essen, Germany
| | - Marcell Baranyi
- Department of Pathology, Forensic and Insurance Medicine, Semmelweis University, Üllöi ut 93, 195, Budapest, Hungary
| | - Martin Schuler
- German Cancer Consortium (DKTK), Partner Site University Hospital Essen, 45122 Essen, Germany; Department of Medical Oncology, West German Cancer Center, University Duisburg-Essen, Hufelandstraße 55, 45147 Essen, German
| | - Sophie Deshayes
- Nantes Université, Inserm UMR 1307, CNRS UMR 6075, Université d'Angers, CRCI2NA, F-44000 Nantes, France
| | - Servet Bölükbas
- Department of Thoracic Surgery, Ruhrlandklinik, West German Cancer Center, University Duisburg-Essen, Tueschener Weg 40, 45239 Essen, Germany
| | - Clemens Aigner
- Department of Thoracic Surgery, Ruhrlandklinik, West German Cancer Center, University Duisburg-Essen, Tueschener Weg 40, 45239 Essen, Germany; German Cancer Consortium (DKTK), Partner Site University Hospital Essen, 45122 Essen, Germany; Karl-Landsteiner-Institute for Clinical and Translational Thoracic Surgery Research, Bruenner Strasse 68, 1210 Vienna, Austria
| | - Christophe Blanquart
- Nantes Université, Inserm UMR 1307, CNRS UMR 6075, Université d'Angers, CRCI2NA, F-44000 Nantes, France
| | - Balazs Hegedüs
- Department of Thoracic Surgery, Ruhrlandklinik, West German Cancer Center, University Duisburg-Essen, Tueschener Weg 40, 45239 Essen, Germany.
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Zhu W, Liu J, Li Y, Shi Z, Wei S. Global, regional, and national trends in mesothelioma burden from 1990 to 2019 and the predictions for the next two decades. SSM Popul Health 2023; 23:101441. [PMID: 37334331 PMCID: PMC10272494 DOI: 10.1016/j.ssmph.2023.101441] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 05/25/2023] [Accepted: 05/28/2023] [Indexed: 06/20/2023] Open
Abstract
Objectives We aimed to analyze the secular trends in mesothelioma burden, the effect of age, period, and birth cohort, and project the global burden over time. Material and methods Based on the mesothelioma incidence, mortality, and Disability-Adjusted Life Years (DALYs) data from 1990 to 2019 in Global Burden of Diseases (GBD) database, the annual percentage change (APC) and average annual percent change (AAPC), calculated from joinpoint regression model, was used to describe the burden trends. An age-period-cohort model was utilized to disentangle age, period, and birth cohort effects on mesothelioma incidence and mortality trends. The mesothelioma burden was projected by the Bayesian age-period-cohort (BAPC) model. Results Globally, there were the significant declines in age-standardized incidence rate (ASIR) (AAPC = -0.4, 95%CI: -0.6,-0.3, P < 0.001), age-standardized mortality rate (ASMR) (AAPC = -0.3, 95%CI: -0.4,-0.2, P < 0.001), and age-standardized DALY rate (ASDR) (AAPC = -0.5, 95%CI: -0.6,-0.4, P < 0.001) of mesothelioma overall 30 years. For regions, Central Europe presented the most distinct increases and the most substantial decrease was observed in Andean Latin America on all ASRs (age-standardized rates) from 1990 to 2019. At national level, the largest annualized growth for full-range trends of incidence, mortality, and DALYs was in Georgia. Conversely, the fastest descent of all ASRs was observed in Peru. The ASIR, ASMR, and ASDR in 2039 predicted 0.33, 0.27, and 6.90 per 100,000, respectively. Conclusions The global burden of mesothelioma declined over the past 30 years, with variability across regions and countries/territories, and this trend will continue in the future.
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Han J, Park S, Yon DK, Lee SW, Woo W, Dragioti E, Koyanagi A, Jacob L, Kostev K, Radua J, Lee S, Shin JI, Smith L. Global, Regional, and National Burden of Mesothelioma 1990-2019: A Systematic Analysis of the Global Burden of Disease Study 2019. Ann Am Thorac Soc 2023; 20:976-983. [PMID: 36857650 DOI: 10.1513/annalsats.202209-802oc] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 03/01/2023] [Indexed: 03/03/2023] Open
Abstract
Rationale: Mesothelioma has become a major health burden since World War II because of the use of asbestos. Although many countries have imposed bans on asbestos, there remain significant mortality and morbidity from mesothelioma because of its long latent period and aggressiveness. Also, the use of asbestos is increasing in low-income countries, potentiating risk of mesothelioma in the coming decades. Assessment of the global burden of mesothelioma is required to take proper measures against the disease. Objectives: To assess the burden of mesothelioma from 1990 to 2019 at the global, regional, and national levels and to investigate patterns according to sex, age, sociodemographic index, and risk factors. Methods: The numbers, rates, and age-standardized rates of incidence, death, and disability-adjusted life years (DALYs) of mesothelioma in 204 countries and territories from 1990 to 2019 were estimated using vital registration and cancer registry data. The relationship between sociodemographic index and age-standardized DALY rate was determined, and DALYs attributable to occupational exposure to asbestos were calculated. Results: In 2019, there were 34,511 (95% uncertainty interval [UI], 31,199 to 37,771) incident cases of mesothelioma globally, with an age-standardized rate of 0.43 per 100,000 persons (95% UI, 0.38 to 0.47), which decreased between 1990 and 2019 by -12.6% (95% UI, -21.8% to -2.3%). Mesothelioma was responsible for 29,251 (95% UI, 26,668 to 31,006) deaths in 2019, with an age-standardized rate of 0.36 deaths per 100,000 persons (95% UI, 0.33 to 0.39), which decreased between 1990 and 2019 by -9.6% (95% UI, -17.8% to -1.1%). The age-standardized incidence rate increased in central Europe between 1990 and 2019 by 46.1% (95% UI, 16.6% to 72.4%). The Netherlands, Australia, and the United Kingdom had the highest age-standardized incidence rates. Incidence rates were higher in men than in women ages 45-49 to 90-94 years, peaking at 85-89 years. Occupational exposure to asbestos contributed to 85.2% (95% UI, 82.1% to 88.1%) of DALYs. Conclusions: The global burden of mesothelioma is decreasing in terms of age-standardized incidence and mortality rates. Mesothelioma remains a substantial public health challenge in many parts of the world.
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Affiliation(s)
- Jonghoon Han
- College of Medicine, Yonsei University, Seoul, Republic of Korea
| | - Seoyeon Park
- College of Medicine, Yonsei University, Seoul, Republic of Korea
| | - Dong Keon Yon
- Medical Science Research Institute and
- Department of Pediatrics, Kyung Hee University Medical Center, College of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Seung Won Lee
- School of Medicine, Sungkyunkwan University, Suwon, Republic of Korea
| | - Wongi Woo
- Department of Thoracic and Cardiovascular Surgery, Gangnam Severance Hospital, and
| | - Elena Dragioti
- Pain and Rehabilitation Centre and
- Department of Health, Medicine and Caring Sciences, Linkoping University, Linkoping, Sweden
| | - Ai Koyanagi
- Unidad de Investigación y Desarrollo, Parc Sanitari Sant Joan de Deu, Sant Boi de Llobregat, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, Barcelona, Spain
- Catalan Institution for Research and Advanced Studies, Barcelona, Spain
| | - Louis Jacob
- Unidad de Investigación y Desarrollo, Parc Sanitari Sant Joan de Deu, Sant Boi de Llobregat, Spain
- University Clinic of Marburg, Marburg, Germany
| | - Karel Kostev
- Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines, Versailles, France
| | - Joaquim Radua
- Imatge dels trastorns relacionats amb l'estat d'ànim i l'ansietat, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Centro de Investigación Biomédica en Red de Salud Mental, University of Barcelona, Barcelona, Spain; and
| | - Sungsoo Lee
- Department of Thoracic and Cardiovascular Surgery, Gangnam Severance Hospital, and
| | | | - Lee Smith
- Centre for Health, Performance, and Wellbeing, Anglia Ruskin University, Cambridge, United Kingdom
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Asbestos Consumption and Malignant Mesothelioma Mortality Trends in the Major User Countries. Ann Glob Health 2023; 89:11. [PMID: 36819965 PMCID: PMC9936915 DOI: 10.5334/aogh.4012] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 01/25/2023] [Indexed: 02/15/2023] Open
Abstract
Background The causal association between mesothelioma and asbestos exposure is conclusive, and many studies have proved that the trend in asbestos use is a strong predictor of the pattern in mesothelioma cases with an adequate latency time (generally around 30-40 years or more). Recently, a novel approach for predicting malignant pleural mesothelioma, based on asbestos consumption trend and using distributed non-linear models, has been applied. Objectives The purpose of this study is to analyse trends in asbestos consumption and malignant mesothelioma mortality in the major asbestos-user countries. Furthermore, we applied distributed non-linear models to estimate and compare epidemiological relationships between asbestos consumption and mesothelioma mortality across these countries. Methods The study involves major asbestos-user countries in which historical asbestos consumption and mesothelioma mortality data are available. Data on asbestos consumption were derived from worldwide asbestos supply and mesothelioma mortality data from World Health Organization (WHO) mortality archives. A quasi-Poisson generalized linear model was used to model past asbestos exposure and male mesothelioma mortality rates in each country. Exposure-response associations have been modelled using distributed lag non-linear models. Findings and conclusions According to the criteria defined above, we selected 18 countries with raw asbestos cumulative consumptions higher than two million tons in the period 1933-2012. Overall, a clear linear relationship can be observed between total consumption and total deaths for mesothelioma. Country-specific exposure, lag and age-response relationships were identified and common functions extracted by a meta-analysis procedure. Non-linear models appear suitable and flexible tools for investigating the association between mesothelioma mortality and asbestos consumption. There is a need to improve the global epidemiological surveillance of asbestos-related diseases, particularly mesothelioma mortality, and the absence of reliable data for some major asbestos-user countries is a real concern. A reliable assessment of mesothelioma mortality is a fundamental step towards increasing the awareness of related risks and the need of an international ban on asbestos.
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Slavik CE, Demers PA, Tamburic L, Warden H, McLeod C. Do patterns of past asbestos use and production reflect current geographic variations of cancer risk?: mesothelioma in Ontario and British Columbia, Canada. Cancer Causes Control 2023; 34:349-360. [PMID: 36729166 PMCID: PMC9971118 DOI: 10.1007/s10552-023-01672-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 01/20/2023] [Indexed: 02/03/2023]
Abstract
PURPOSE Canada was a major global asbestos producer and consumer. Geographic patterns of Canadian asbestos use and mesothelioma, a highly fatal cancer linked to asbestos exposure, have not been previously reported. This study summarized key trends in mesothelioma incidence by geography and time in two Canadian provinces, Ontario and British Columbia (BC), and explored how past workforce characteristics and geographic trends in asbestos production and use may shape variations in regional rates of mesothelioma. METHODS We report trends in mesothelioma incidence (1993-2016) for Ontario and British Columbia using population-based incidence data that were age-standardized to the 2011 Canadian population. Historical records of asbestos production and use were analyzed to geo-locate industrial point sources of asbestos in Ontario and BC. The prevalence of occupations in regions with the highest and lowest rates of mesothelioma in Ontario and BC were calculated using labor force statistics from the 1981 Canadian Census. RESULTS Regional mesothelioma rates varied in both provinces over time; more census divisions in both Ontario and BC registered mesothelioma rates in the highest quintile of incidences during the period 2009 to 2016 than in any prior period examined. Certain occupations such as construction trades workers were more likely to be overrepresented in regions with high mesothelioma rates. CONCLUSION This work explored how studying asbestos exposure and mesothelioma incidence at small-scale geographies could direct cancer surveillance and research to more targeted areas. Findings indicated that regional variations in mesothelioma could signal important differences in past occupational and potentially environmental exposures.
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Affiliation(s)
- Catherine E. Slavik
- grid.419887.b0000 0001 0747 0732Occupational Cancer Research Centre, Ontario Health (Cancer Care Ontario), Toronto, ON M5G 1X3 Canada
| | - Paul A. Demers
- grid.419887.b0000 0001 0747 0732Occupational Cancer Research Centre, Ontario Health (Cancer Care Ontario), Toronto, ON M5G 1X3 Canada ,grid.17063.330000 0001 2157 2938Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5T 3M7 Canada
| | - Lillian Tamburic
- grid.17091.3e0000 0001 2288 9830Partnership for Work, Health and Safety, School of Population and Public Health, University of British Columbia, Vancouver, BC V6T 1Z3 Canada
| | - Hunter Warden
- grid.419887.b0000 0001 0747 0732Occupational Cancer Research Centre, Ontario Health (Cancer Care Ontario), Toronto, ON M5G 1X3 Canada ,grid.17063.330000 0001 2157 2938Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8 Canada
| | - Christopher McLeod
- grid.17091.3e0000 0001 2288 9830Partnership for Work, Health and Safety, School of Population and Public Health, University of British Columbia, Vancouver, BC V6T 1Z3 Canada
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11
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Chimed-Ochir O, Rath EM, Kubo T, Yumiya Y, Lin RT, Furuya S, Brislane K, Klebe S, Nowak AK, Kang SK, Takahashi K. Must countries shoulder the burden of mesothelioma to ban asbestos? A global assessment. BMJ Glob Health 2022; 7:bmjgh-2022-010553. [PMID: 36543384 PMCID: PMC9772623 DOI: 10.1136/bmjgh-2022-010553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 11/19/2022] [Indexed: 12/24/2022] Open
Abstract
INTRODUCTION Mesothelioma is a key asbestos-related disease (ARD) but can be difficult to diagnose. Countries presumably ban asbestos to reduce future ARD burdens, but it is unknown if countries ban asbestos as a consequence of ARD burdens. We assessed if and to what extent mesothelioma burden has an impact on a country banning asbestos and obtaining targets for preventative strategies. METHODS We analysed the status of asbestos ban and mesothelioma burden during 1990-2019 in 198 countries. We assessed mesothelioma burden by age-adjusted mortality rates (MRs) estimated by the Global Burden of Disease Study (GBD) and mesothelioma identification by the WHO mortality database. For GBD-estimated mesothelioma MR, the pre-ban period in the asbestos-banned countries was compared with the 1990-2019 period in the not-banned countries. For mesothelioma identification, the 1990-2019 period was applied to both banned and not-banned countries. RESULTS The association of mesothelioma MR with ban status increased as the ban year approached. Logistic regression analyses showed that the odds of a country banning asbestos increased 14.1-fold (95% CI 5.3 to 37.9) for mesothelioma identification combined with a 26% (12% to 42%) increase per unit increase of mesothelioma MR (one death per million per year) during the period 1-5 year before ban (model p<0.0001). CONCLUSION Mesothelioma burden had an impact on, and together with its identification, explained the banning of asbestos in many countries. Asbestos-banned countries likely learnt lessons from their historical policies of using asbestos because mesothelioma burden and identification follow historical asbestos use. Prevention targets for ARD elimination should combine asbestos ban with mesothelioma identification.
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Affiliation(s)
- Odgerel Chimed-Ochir
- Department of Public Health and Health Policy, Hiroshima University, Hiroshima, Japan,Asbestos Diseases Research Institute, Sydney, New South Wales, Australia
| | - Emma M Rath
- Asbestos Diseases Research Institute, Sydney, New South Wales, Australia,Victor Chang Cardiac Research Institute, Sydney, New South Wales, Australia
| | - Tatsuhiko Kubo
- Department of Public Health and Health Policy, Hiroshima University, Hiroshima, Japan
| | - Yui Yumiya
- Department of Public Health and Health Policy, Hiroshima University, Hiroshima, Japan
| | - Ro-Ting Lin
- Asbestos Diseases Research Institute, Sydney, New South Wales, Australia,Department of Occupational Safety and Health, China Medical University, Taichung, Taiwan
| | - Sugio Furuya
- Japan Occupational Safety and Health Resource Center, Tokyo, Japan
| | - Kim Brislane
- Asbestos Diseases Research Institute, Sydney, New South Wales, Australia
| | - Sonja Klebe
- Asbestos Diseases Research Institute, Sydney, New South Wales, Australia,Department of Pathology, Flinders University, Adelaide, South Australia, Australia
| | - Anna K Nowak
- Asbestos Diseases Research Institute, Sydney, New South Wales, Australia,National Centre for Asbestos Related Diseases, Institute for Respiratory Health, University of Western Australia, Nedlands, WA, Australia,Medical School, University of Western Australia, Nedlands, WA, Australia
| | - Seong-Kyu Kang
- Gachon University College of Medicine, Incheon, Korea (the Republic of)
| | - Ken Takahashi
- Asbestos Diseases Research Institute, Sydney, New South Wales, Australia,School of Population and Global Health, University of Western Australia, Perth, Western Australia, Australia,University of Occupational and Environmental Health, Kitakyushu, Japan,JEOL Ltd, Tokyo, Japan
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12
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Jeffers D, Liao YC, Takahashi K, Lin RT. Asbestos awareness among the residents of St. Kitts and Nevis: a cross-sectional study. Global Health 2022; 18:83. [PMID: 36153532 PMCID: PMC9509556 DOI: 10.1186/s12992-022-00874-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 09/08/2022] [Indexed: 11/23/2022] Open
Abstract
Background High levels of public awareness regarding the hazards of asbestos, rights to health, and benefits of an asbestos-free country can increase advocacy and political commitment to a total ban on asbestos. We aimed to investigate asbestos awareness and associated sociodemographic characteristics among the adult population of St. Kitts and Nevis. Methods In this cross-sectional study, 1009 participants completed an online questionnaire with questions about sociodemographic data and asbestos awareness. We applied multiple regression models to estimate associations between sociodemographic factors, levels of asbestos knowledge, and attitudes toward asbestos management. Results We found that 70% of residents of St. Kitts and Nevis considered asbestos exposure to be a general public concern and believed the government should prevent it. Of all participants, 54% were in favor of completely banning the use and importation of all asbestos products and materials; those with higher levels of asbestos knowledge were more likely to favor a total ban. Higher proportions and odds of favoring a total asbestos ban were also observed in participants aged ≥ 30 years, women, those with higher education, and those living in St. Kitts (vs. Nevis). Conclusions These findings support implementing policies to regulate and outright ban the use of asbestos products and materials in St. Kitts and Nevis. This data can be used to develop tailored campaigns to improve asbestos knowledge among sociodemographic groups with lower asbestos awareness, such as in the wider Caribbean and other under-resourced countries. Supplementary Information The online version contains supplementary material available at 10.1186/s12992-022-00874-w.
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Global magnitude and temporal trend of mesothelioma burden along with the contribution of occupational asbestos exposure in 204 countries and territories from 1990 to 2019: Results from the Global Burden of Disease Study 2019. Crit Rev Oncol Hematol 2022; 179:103821. [PMID: 36165817 DOI: 10.1016/j.critrevonc.2022.103821] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 09/15/2022] [Accepted: 09/15/2022] [Indexed: 11/23/2022] Open
Abstract
Understanding the burden of mesothelioma with the contribution of occupational asbestos exposure globally provides essential foundations for cancer control, policy decisions and resource allocation. Globally, 34,511 incident cases, 29,251 deaths and 668,104 disability-adjusted life years (DALYs) of mesothelioma were estimated in 2019. The age-standardized rates of incidence, mortality and DALYs all showed a slightly declining trend over the past 30 years, but the latest absolute number of mesothelioma burden almost doubled since 1990. The burden rate decreased among the population aged under 70 years, but increased among the population aged over 80 years, especially in the High socio-demographic index (SDI) region. The burden rate of mesothelioma attributable to asbestos exposure was positively associated with SDI at the national level. This study depicted a continuous increase in mesothelioma burden globally over the past 30 years. Controlling occupational asbestos exposure will reduce the mesothelioma burden, especially for higher SDI regions.
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The silent malignant mesothelioma epidemic: a call to action. Lancet Oncol 2022. [DOI: 10.1016/s1470-2045(22)00269-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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15
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Kriebel D, Myers DJ. Invited Perspective: Eliminating Toxics to Prevent Disease: Asbestos Leads the Way. ENVIRONMENTAL HEALTH PERSPECTIVES 2022; 130:51305. [PMID: 35622388 PMCID: PMC9138503 DOI: 10.1289/ehp11362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 05/02/2022] [Accepted: 05/04/2022] [Indexed: 06/15/2023]
Affiliation(s)
- David Kriebel
- Lowell Center for Sustainable Production, University of Massachusetts Lowell, Lowell, Massachusetts, USA
| | - Douglas J. Myers
- Department of Public Health and Population Science, College of Health Sciences, Boise State University, Boise, Idaho, USA
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Rath EM, Yuen ML, Odgerel CO, Lin RT, Soeberg M, Nowak AK, Takahashi K. The Ecological Association between Asbestos Consumption and Asbestos-Related Diseases 15 Years Later. ENVIRONMENTAL HEALTH PERSPECTIVES 2022; 130:57703. [PMID: 35622389 PMCID: PMC9138507 DOI: 10.1289/ehp11148] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 04/06/2022] [Accepted: 05/04/2022] [Indexed: 06/15/2023]
Affiliation(s)
- Emma M. Rath
- Giannoulatou Laboratory, Victor Chang Cardiac Research Institute, Sydney, Australia
- Asbestos Diseases Research Institute, Sydney, Australia
- School of Medical Sciences, University of New South Wales, Sydney, Australia
| | - Man Lee Yuen
- Asbestos Diseases Research Institute, Sydney, Australia
| | - Chimed-Ochir Odgerel
- Asbestos Diseases Research Institute, Sydney, Australia
- Graduate School of Biomedical and Health Sciences, University of Hiroshima, Hiroshima, Japan
| | - Ro-Ting Lin
- Asbestos Diseases Research Institute, Sydney, Australia
- Department of Occupational Safety and Health, College of Public Health, China Medical University, Taichung, Taiwan
| | | | - Anna K. Nowak
- Asbestos Diseases Research Institute, Sydney, Australia
- Medical School, University of Western Australia, Perth, Australia
- National Centre for Asbestos Related Diseases, Institute for Respiratory Health, Perth, Australia
| | - Ken Takahashi
- Asbestos Diseases Research Institute, Sydney, Australia
- School of Population and Global Health, University of Western Australia, Perth, Australia
- University of Occupational and Environmental Health, Kitakyushu, Japan
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17
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Belackova L, Verbeek JH, Hoving JL, van der Molen HF, Gagliardi D, Curti S, Hulshof CTJ, Scheepers PTJ, Marinaccio A. Legal banning of asbestos for preventing asbestos exposure. Hippokratia 2022. [DOI: 10.1002/14651858.cd015106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Lea Belackova
- Cochrane Work, Coronel Institute of Occupational Health; Amsterdam UMC ; Amsterdam Netherlands
| | - Jos H Verbeek
- Cochrane Work, Coronel Institute of Occupational Health; Amsterdam UMC ; Amsterdam Netherlands
| | - Jan L Hoving
- Cochrane Work, Coronel Institute of Occupational Health; Amsterdam UMC ; Amsterdam Netherlands
| | | | - Diana Gagliardi
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene; INAIL; Rome Italy
| | - Stefania Curti
- Department of Medical and Surgical Sciences; University of Bologna; Bologna Italy
| | - Carel TJ Hulshof
- Netherlands Society of Occupational Medicine (NVAB); Centre of Excellence; Utrecht Netherlands
| | - Paul TJ Scheepers
- Radboud Institute for Health Sciences; Radboudumc; Nijmegen Netherlands
- Healt Evidence; Radboudumc; NIjmegen Netherlands
| | - Alessandro Marinaccio
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene; INAIL; Rome Italy
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18
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A Real-World Analysis of the use of Systemic Therapy in Malignant Pleural Mesothelioma and the Differential Impacts on Overall Survival by Practice Pattern. JTO Clin Res Rep 2022; 3:100280. [PMID: 35243411 PMCID: PMC8861643 DOI: 10.1016/j.jtocrr.2022.100280] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 12/20/2021] [Accepted: 01/10/2022] [Indexed: 11/28/2022] Open
Abstract
Introduction Malignant pleural mesothelioma (MPM) is an aggressive malignancy that affects older adults with frequent comorbidities, making real-world treatment decisions challenging. This study compares the overall survival (OS) of patients with MPM by physician’s choice of first-line (1L) platinum chemotherapy (PC), second-line (2L) immunotherapy versus chemotherapy, and by receipt of maintenance therapy (MT). Methods The study included patients diagnosed with advanced MPM in the Flatiron Health electronic health record–derived database who initiated PC with pemetrexed in the 1L setting between 2011 and 2019. Patients in the 2L therapy analysis received single-agent chemotherapy versus immunotherapy after the progression of disease from our 1L cohort. Patients in the MT cohort were identified on the basis of continued receipt of pemetrexed with or without bevacizumab after dropping PC at prespecified intervals. The OS of patients by choice of 1L PC, 2L immunotherapy versus chemotherapy, and receipt of MT was summarized by means of Kaplan-Meier survival estimates and compared in the context of propensity score matching weighted analyses. Results In propensity score matching weighting analysis from 2065 patients with MPM, there was no evidence of an OS difference by choice of 1L PC (hazard ratio [HR] = 1.08, 95% confidence interval [CI]: 0.89–1.31, p = 0.43), suggestive evidence of an OS difference by choice of 2L immunotherapy versus chemotherapy (HR = 0.68, 95% CI: 0.42–1.08; p = 0.10), and no evidence of an OS difference by receipt of MT (HR = 0.92, 95% CI: 0.72–1.16, p = 0.46). Conclusions Using real-world, propensity score–matched weighted analysis of MPM, we found there was no difference in OS by choice of 1L PC, 2L immunotherapy or chemotherapy, or by receipt of MT.
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Schulte JJ, Chapel DB, Attanoos R, Brcic L, Burn J, Butnor KJ, Chang N, Chen H, Dacic S, De Perrot M, Fukuoka J, Galateau-Salle F, Godschachner T, Hiroshima K, Klebe S, Krausz T, Litzky L, Marchevsky AM, Mueller J, Nabeshima K, Nicholson AG, Pal P, Roden AC, Rorvig S, Santoni-Rugiu E, Tazelaar H, Tsao MS, Walts AE, Weynand B, Zaizen Y, Zhang YZ, Husain AN. Comparison of Nuclear Grade, Necrosis, and Histologic Subtype Between Biopsy and Resection in Pleural Malignant Mesothelioma: An International Multi-Institutional Analysis. Am J Clin Pathol 2021; 156:989-999. [PMID: 33978147 DOI: 10.1093/ajcp/aqab054] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
OBJECTIVES Numerous studies on malignant mesothelioma (MM) highlight the prognostic importance of histologic subtype, nuclear grade, and necrosis. This study compares these parameters in paired biopsy and resection specimens of pleural MM. METHODS Histologic subtype, percentage of epithelioid morphology, nuclear grade, and the presence or absence of necrosis were compared in 429 paired biopsies and resection specimens of pleural MM from 19 institutions. RESULTS Histologic subtype was concordant in 81% of cases (κ = 0.58). When compared with resection specimens, epithelioid morphology at biopsy had a positive predictive value (PPV) of 78.9% and a negative predictive value (NPV) of 93.5%; sarcomatoid morphology showed high PPV (92.9%) and NPV (99.3%), and biphasic morphology PPV was 89.7% and NPV was 79.7%. Agreement of the percentage of epithelioid morphology was fair (κ = 0.27). Nuclear grade and necrosis were concordant in 75% (κ = 0.59) and 81% (κ = 0.53) of cases, respectively. Nuclear grade showed moderate (κ = 0.53) and substantial (κ = 0.67) agreement from patients with and without neoadjuvant therapy, respectively, and necrosis showed moderate (κ = 0.47 and κ = 0.60) agreement, respectively, in the same subsets of paired specimens. CONCLUSIONS Paired biopsy-resection specimens from pleural MM show overall moderate agreement in pathologic parameters. These findings may help guide postbiopsy management and triage of patients with MM.
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Affiliation(s)
- Jefree J Schulte
- Department of Pathology, University of Chicago, Chicago, IL, USA
- Department of Pathology and Lab Medicine, University of Wisconsin, Madison, WI, USA
| | - David B Chapel
- Department of Pathology, University of Chicago, Chicago, IL, USA
- Department of Pathology, Brigham and Women’s Hospital, Boston, MA, USA
| | - Richard Attanoos
- Department of Cellular Pathology, University Hospital of Wales and School of Medicine, Cardiff University, Cardiff, UK
| | - Luka Brcic
- Diagnostics and Research Institute of Pathology, Medical University of Graz, Graz, Austria
| | - Juliet Burn
- Douglass Hanly Moir Pathology, Sydney, Australia
| | - Kelly J Butnor
- Department of Pathology, University of Vermont Medical Center, Burlington, VT, USA
| | - Nina Chang
- Department of Laboratory Medicine and Pathobiology, University Health Network, Toronto, Canada
| | - Heather Chen
- Department of Pathology, University of Chicago, Chicago, IL, USA
| | - Sanja Dacic
- Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Marc De Perrot
- Department of Laboratory Medicine and Pathobiology, University Health Network, Toronto, Canada
| | - Junya Fukuoka
- Department of Pathology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | | | - Theresa Godschachner
- Diagnostics and Research Institute of Pathology, Medical University of Graz, Graz, Austria
| | - Kenzo Hiroshima
- Department of Pathology, Tokyo Women’s Medical University Yachiyo Medical Center, Yachiyo, Japan
| | - Sonja Klebe
- Department of Anatomical Pathology, SA Pathology, Flinders University, Adelaide, Australia
| | - Thomas Krausz
- Department of Pathology, University of Chicago, Chicago, IL, USA
| | - Leslie Litzky
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Alberto M Marchevsky
- Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Jeffrey Mueller
- Department of Pathology, University of Chicago, Chicago, IL, USA
| | - Kazuki Nabeshima
- Department of Pathology, Fukuoka University Hospital, Fukuoka, Japan
| | - Andrew G Nicholson
- Department of Histopathology, Royal Brompton and Harefield NHS Foundation Trust and National Heart and Lung Institute, Imperial College, London, UK
| | - Prodipto Pal
- Department of Laboratory Medicine and Pathobiology, University Health Network, Toronto, Canada
| | - Anja C Roden
- Department of Laboratory Medicine and Pathology; Mayo Clinic, Rochester, MN, USA
| | - Sara Rorvig
- Department of Pathology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Eric Santoni-Rugiu
- Department of Pathology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Henry Tazelaar
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Scottsdale, AZ, USA
| | - Ming-Sound Tsao
- Department of Laboratory Medicine and Pathobiology, University Health Network, Toronto, Canada
| | - Ann E Walts
- Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Birgit Weynand
- Department of Pathology, Universitair Ziekenhuis Leuven, Leuven, Belgium
| | - Yoshiaki Zaizen
- Department of Pathology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Yu Zhi Zhang
- Department of Histopathology, Royal Brompton and Harefield NHS Foundation Trust and National Heart and Lung Institute, Imperial College, London, UK
| | - Aliya N Husain
- Department of Pathology, University of Chicago, Chicago, IL, USA
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Hyperthermic Intrathoracic Chemotherapy for Malignant Pleural Mesothelioma: The Forefront of Surgery-Based Multimodality Treatment. J Clin Med 2021; 10:jcm10173801. [PMID: 34501249 PMCID: PMC8432004 DOI: 10.3390/jcm10173801] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 08/12/2021] [Accepted: 08/18/2021] [Indexed: 12/03/2022] Open
Abstract
Introduction: Malignant Pleural Mesothelioma (MPM) is characterized by an aggressive behavior and an inevitably fatal prognosis, whose treatment is still far from being standardized. The role of surgery is questionable since a radical resection is unattainable in most cases. Hyperthermic IntraTHOracic Chemotherapy (HITHOC) combines the advantages of antitumoral effects together with those of high temperature on the exposed tissues with the aim to improve surgical radicality. Material and Methods: this is a narrative review on the role of HITHOC in the management of MPM patients. To provide data on the beginnings and the historical evolution of this technique, we searched the available literature by selecting the more exhaustive papers on this topic. Results: from 1994 to date different authors experimented HITHOC following a cytoreductive surgery in MPM, obtaining in most cases a good local control and a better overall survival associated to very low complication rate. Conclusions: HITHOC may be considered as a safe, feasible and effective procedure although there is a high heterogeneity between different protocols adopted worldwide. More structured studies are needed to reach a unanimous consensus on this technique.
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Luna J, Bobo A, Cabrera-Rodriguez JJ, Pagola M, Martín-Martín M, Ruiz MÁG, Montijano M, Rodríguez A, Pelari-Mici L, Corbacho A, Moreno M, Couñago F. GOECP/SEOR clinical guidelines on radiotherapy for malignant pleural mesothelioma. World J Clin Oncol 2021; 12:581-608. [PMID: 34513595 PMCID: PMC8394157 DOI: 10.5306/wjco.v12.i8.581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Revised: 05/12/2021] [Accepted: 07/06/2021] [Indexed: 02/06/2023] Open
Abstract
Malignant pleural mesothelioma (MPM) is a rare tumor with poor prognosis and rising incidence. Palliative care is common in MPM as radical treatment with curative intent is often not possible due to metastasis or extensive locoregional involvement. Numerous therapeutic advances have been made in recent years, including the use of less aggressive surgical techniques associated with lower morbidity and mortality (e.g., pleurectomy/decortication), technological advancements in the field of radiotherapy (intensity-modulated radiotherapy, image-guided radiotherapy, stereotactic body radiotherapy, proton therapy), and developments in systemic therapies (chemotherapy and immunotherapy). These improvements have had as yet only a modest effect on local control and survival. Advances in the management of MPM and standardization of care are hampered by the evidence to date, limited by high heterogeneity among studies and small sample sizes. In this clinical guideline prepared by the oncological group for the study of lung cancer of the Spanish Society of Radiation Oncology, we review clinical, histologic, and therapeutic aspects of MPM, with a particular focus on all aspects relating to radiotherapy, including the current evidence base, associations with chemotherapy and surgery, treatment volumes and planning, technological advances, and reradiation.
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Affiliation(s)
- Javier Luna
- Department of Radiation Oncology, Institute of Oncohealth, Fundación Jiménez Díaz, Madrid 28040, Spain
| | - Andrea Bobo
- Department of Radiation Oncology, Institution of Ruber Internacional Hospital, Madrid 28034, Spain
| | | | - María Pagola
- Department of Radiation Oncology, Institution of Onkologikoa/Hospital Universitario Donostia, San Sebastián 20014, Spain
| | - Margarita Martín-Martín
- Department of Radiation Oncology, Institution of Hospital Universitario Ramón y Cajal, Madrid 28034, Spain
| | - María Ángeles González Ruiz
- Department of Radiation Oncology, Institution of Hospital Universitario Virgen de la Macarena, Sevilla 41009, Spain
| | - Miguel Montijano
- Department of Radiation Oncology, Institution of Genesis care Spain, Madrid 28005, Spain
| | - Aurora Rodríguez
- Department of Radiation Oncology, Institution of Ruber Internacional Hospital, Madrid 28034, Spain
| | - Lira Pelari-Mici
- Department of Radiation Oncology, Institution of Hospital Universitario Ramón y Cajal, Madrid 28034, Spain
| | - Almudena Corbacho
- Department of Radiation Oncology, Institution of Hospital de Mérida, Mérida 06800, Spain
| | - Marta Moreno
- Department of Oncology, Institution of University Navarra, Clinical University, Pamplona 31008, Spain
| | - Felipe Couñago
- Department of Radiation Oncology, Institution of Hospital Universitario Quirónsalud and Hospital LaLuz, European University of Madrid, Madrid 28028, Spain
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22
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Zhai Z, Ruan J, Zheng Y, Xiang D, Li N, Hu J, Shen J, Deng Y, Yao J, Zhao P, Wang S, Yang S, Zhou L, Wu Y, Xu P, Lyu L, Lyu J, Bergan R, Chen T, Dai Z. Assessment of Global Trends in the Diagnosis of Mesothelioma From 1990 to 2017. JAMA Netw Open 2021; 4:e2120360. [PMID: 34379126 PMCID: PMC8358735 DOI: 10.1001/jamanetworkopen.2021.20360] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
IMPORTANCE It is difficult for policy makers and clinicians to formulate targeted management strategies for mesothelioma because data on current epidemiological patterns worldwide are lacking. OBJECTIVE To evaluate the mesothelioma burden across the world and describe its epidemiological distribution over time and by sociodemographic index (SDI) level, geographic location, sex, and age. DESIGN, SETTING, AND PARTICIPANTS Annual case data and age-standardized rates of incidence, death, and disability-adjusted life-years associated with mesothelioma among different age groups were obtained from the Global Burden of Disease 2017 database. The estimated annual percentage changes in age-standardized rates were calculated to evaluate temporal trends in incidence and mortality. The study population comprised individuals from 21 regions in 195 countries and territories who were diagnosed with mesothelioma between 1990 and 2017. Data were collected from May 23, 2019, to January 18, 2020. MAIN OUTCOMES AND MEASURES Primary outcomes were incident cases, deaths, and their age-standardized rates and estimated annual percentage changes. Secondary outcomes were disability-adjusted life-years and relative temporal trends. RESULTS Overall, 34 615 new cases (95% uncertainty interval [UI], 33 530-35 697 cases) of mesothelioma and 29 909 deaths (95% UI, 29 134-30 613 deaths) associated with mesothelioma were identified in 2017, and more than 70% of these cases and deaths were among male individuals. In 1990, the number of incident cases was 21 224 (95% UI, 17 503-25 450), and the number of deaths associated with mesothelioma was 17 406 (95% UI, 14 495-20 660). These numbers increased worldwide from 1990 to 2017, with more than 50% of cases recorded in regions with high SDI levels, whereas the age-standardized incidence rate (from 0.52 [95% UI, 0.43-0.62] in 1990 to 0.44 [95% UI, 0.42-0.45] in 2017) and the age-standardized death rate (from 0.44 [95% UI, 0.37-0.52] in 1990 to 0.38 [95% UI, 0.37-0.39] in 2017) decreased, with estimated annual percentage changes of -0.61 (95% CI, -0.67 to -0.54) for age-standardized incidence rate and -0.44 (95% CI, -0.52 to -0.37) for age-standardized death rate. The proportion of incident cases among those 70 years or older continued to increase (from 36.49% in 1990 to 44.67% in 2017), but the proportion of patients younger than 50 years decreased (from 16.74% in 1990 to 13.75% in 2017) over time. In addition, mesothelioma incident cases and age-standardized incidence rates began to decrease after 20 years of a complete ban on asbestos use. For example, in Italy, a complete ban on asbestos went into effect in 1992; incident cases increased from 1409 individuals (95% UI, 1013-1733 individuals) in 1990, peaked in 2015 after 23 years of the asbestos ban, then decreased from 1820 individuals (95% UI, 1699-1981 individuals) in 2015 to 1746 individuals (95% UI, 1555-1955 individuals) in 2017. CONCLUSIONS AND RELEVANCE This cross-sectional study found that incident cases of mesothelioma and deaths associated with mesothelioma continuously increased worldwide, especially in resource-limited regions with low SDI levels. Based on these findings, global governments and medical institutions may consider formulating optimal policies and strategies for the targeted prevention and management of mesothelioma.
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Affiliation(s)
- Zhen Zhai
- Department of Breast Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
- Department of Oncology, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Jian Ruan
- Department of Medical Oncology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Yi Zheng
- Department of Breast Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
- Department of Oncology, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Dong Xiang
- Celilo Cancer Center, Oregon Health Science Center Affiliated Mid-Columbia Medical Center, The Dalles, Oregon
| | - Na Li
- Department of Breast Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
- Department of Oncology, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Jingjing Hu
- Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts
| | - Jianfei Shen
- Department of Cardiothoracic Surgery, Taizhou Hospital of Zhejiang Province, Wenzhou Medical University, Linhai, China
| | - Yujiao Deng
- Department of Breast Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
- Department of Oncology, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Jia Yao
- Department of Breast Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Peng Zhao
- Department of Medical Oncology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Shuqian Wang
- Department of Breast Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Si Yang
- Department of Breast Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
- Department of Oncology, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Linghui Zhou
- Department of Breast Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
- Department of Oncology, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Ying Wu
- Department of Breast Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
- Department of Oncology, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Peng Xu
- Department of Oncology, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Lijuan Lyu
- Department of Oncology, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Jun Lyu
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Raymond Bergan
- Knight Cancer Institute, Oregon Health and Science University, Portland
| | - Tianhui Chen
- Department of Cancer Prevention/Experimental Research Center, Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Hangzhou, China
- Institute of Basic Medicine and Cancer, Chinese Academy of Sciences, Hangzhou, China
| | - Zhijun Dai
- Department of Breast Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
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Fang YJ, Chuang HY, Pan CH, Chang YY, Cheng Y, Lee LJH, Wang JD. Increased Risk of Gastric Cancer in Asbestos-Exposed Workers: A Retrospective Cohort Study Based on Taiwan Cancer Registry 1980-2015. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18147521. [PMID: 34299971 PMCID: PMC8303218 DOI: 10.3390/ijerph18147521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 07/11/2021] [Accepted: 07/13/2021] [Indexed: 12/24/2022]
Abstract
Asbestos has been recognized as a human carcinogen associated with malignant mesothelioma, cancers of lung, larynx, and ovary. However, a putative association between gastric cancer and asbestos exposure remains controversial. In this study, we aimed to explore gastric cancer risk of workers potentially exposed to asbestos in Taiwan. The asbestos occupational cohort was established from 1950 to 2015 based on the Taiwan Labor Insurance Database, and Taiwan Environmental Protection Agency regulatory datasets, followed by the Taiwan Cancer Registry for the period 1980–2015. Standardized incidence ratios (SIRs) for cancer were computed for the whole cohort using reference rates of the general population, and also reference labor population. Compared with the general population, SIR of the asbestos occupational cohort for the gastric cancer increased both in males (1.05, 95% confidence interval (CI): 1.02–1.09) and females (1.10, 95% CI: 1.01–1.18). A total of 123 worksites were identified to have cases of malignant mesothelioma, where increased risk for gastric cancer was found with a relative risk of 1.76 (95% CI: 1.63–1.90). This 35-year retrospective cohort study of asbestos-exposed workers in Taiwan may provide support for an association between occupational exposure to asbestos and gastric cancer.
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Affiliation(s)
- Yi-Jen Fang
- Ph.D. Program in Environmental and Occupational Medicine, College of Medicine, Kaohsiung Medical University and National Health Research Institutes, Kaohsiung 807, Taiwan; (Y.-J.F.); (H.-Y.C.)
- Digestive Disease Center, Show-Chwan Memorial Hospital, Changhua 500, Taiwan
| | - Hung-Yi Chuang
- Ph.D. Program in Environmental and Occupational Medicine, College of Medicine, Kaohsiung Medical University and National Health Research Institutes, Kaohsiung 807, Taiwan; (Y.-J.F.); (H.-Y.C.)
- Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
- Department of Environmental and Occupational Medicine, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan
| | - Chih-Hong Pan
- Institute of Labor, Occupational Safety and Health, Ministry of Labor, New Taipei City 221, Taiwan;
| | - Yu-Yin Chang
- National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli County 350, Taiwan;
| | - Yawen Cheng
- Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taipei 100, Taiwan;
| | - Lukas Jyuhn-Hsiarn Lee
- Ph.D. Program in Environmental and Occupational Medicine, College of Medicine, Kaohsiung Medical University and National Health Research Institutes, Kaohsiung 807, Taiwan; (Y.-J.F.); (H.-Y.C.)
- Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
- National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli County 350, Taiwan;
- Institute of Environmental and Occupational Health Sciences, College of Public Health, National Taiwan University, Taipei 100, Taiwan
- Correspondence: ; Tel.: +886-37-206166 (ext. 36512)
| | - Jung-Der Wang
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan;
- Department of Occupational and Environmental Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan
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24
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Oddone E, Bollon J, Nava CR, Consonni D, Marinaccio A, Magnani C, Gasparrini A, Barone-Adesi F. Effect of Asbestos Consumption on Malignant Pleural Mesothelioma in Italy: Forecasts of Mortality up to 2040. Cancers (Basel) 2021; 13:3338. [PMID: 34283067 PMCID: PMC8267929 DOI: 10.3390/cancers13133338] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 06/30/2021] [Indexed: 12/31/2022] Open
Abstract
Statistical models used to forecast malignant pleural mesothelioma (MPM) trends often do not take into account historical asbestos consumption, possibly resulting in less accurate predictions of the future MPM death toll. We used the distributed lag non-linear model (DLNM) approach to predict future MPM cases in Italy until 2040, based on past asbestos consumption figures. Analyses were conducted using data on male MPM deaths (1970-2014) and annual asbestos consumption using data on domestic production, importation, and exportation. According to our model, the peak of MPM deaths is expected to occur in 2021 (1122 expected cases), with a subsequent decrease in mortality (344 MPM deaths in 2039). The exposure-response curve shows that relative risk (RR) of MPM increased almost linearly for lower levels of exposure but flattened at higher levels. The lag-specific RR grew until 30 years since exposure and decreased thereafter, suggesting that the most relevant contributions to the risk come from exposures which occurred 20-40 years before death. Our results show that the Italian MPM epidemic is approaching its peak and underline that the association between temporal trends of MPM and time since exposure to asbestos is not monotonic, suggesting a lesser role of remote exposures in the development of MPM than previously assumed.
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Affiliation(s)
- Enrico Oddone
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, via Severino Boezio 24, 27100 Pavia, Italy
- Occupational Medicine Unit (UOOML), ICS Maugeri IRCCS, 27100 Pavia, Italy
| | - Jordy Bollon
- Department of Translational Medicine, University of Eastern Piedmont, 28100 Novara, Italy; (J.B.); (C.M.); (F.B.-A.)
| | - Consuelo Rubina Nava
- Department of Economics and Statistics ‘Cognetti de Martiis’, University of Turin, 10124 Turin, Italy;
| | - Dario Consonni
- Epidemiology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy;
| | - Alessandro Marinaccio
- Occupational and Environmental Medicine, Epidemiology and Hygiene Department, Italian Workers’ Compensation Authority (INAIL), 00187 Rome, Italy;
| | - Corrado Magnani
- Department of Translational Medicine, University of Eastern Piedmont, 28100 Novara, Italy; (J.B.); (C.M.); (F.B.-A.)
| | - Antonio Gasparrini
- Department of Public Health Environments and Society, London School of Hygiene & Tropical Medicine, London WC1H 9SH, UK;
- Centre for Statistical Methodology, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK
| | - Francesco Barone-Adesi
- Department of Translational Medicine, University of Eastern Piedmont, 28100 Novara, Italy; (J.B.); (C.M.); (F.B.-A.)
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25
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Désage AL, Karpathiou G, Peoc’h M, Froudarakis ME. The Immune Microenvironment of Malignant Pleural Mesothelioma: A Literature Review. Cancers (Basel) 2021; 13:3205. [PMID: 34206956 PMCID: PMC8269097 DOI: 10.3390/cancers13133205] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 06/16/2021] [Accepted: 06/22/2021] [Indexed: 12/13/2022] Open
Abstract
Malignant pleural mesothelioma (MPM) is a rare and aggressive tumour with a poor prognosis, associated with asbestos exposure. Nowadays, treatment is based on chemotherapy with a median overall survival of less than two years. This review highlights the main characteristics of the immune microenvironment in MPM with special emphasis on recent biological advances. The MPM microenvironment is highly infiltrated by tumour-associated macrophages, mainly M2-macrophages. In line with infiltration by M2-macrophages, which contribute to immune suppression, other effectors of innate immune response are deficient in MPM, such as dendritic cells or natural killer cells. On the other hand, tumour infiltrating lymphocytes (TILs) are also found in MPM, but CD4+ and CD8+ TILs might have decreased cytotoxic effects through T-regulators and high expression of immune checkpoints. Taken together, the immune microenvironment is particularly heterogeneous and can be considered as mainly immunotolerant or immunosuppressive. Therefore, identifying molecular vulnerabilities is particularly relevant to the improvement of patient outcomes and the assessment of promising treatment approaches.
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Affiliation(s)
- Anne-Laure Désage
- Department of Pulmonology and Thoracic Oncology, North Hospital, University Hospital of Saint-Etienne, 42055 Saint-Etienne, France;
| | - Georgia Karpathiou
- Pathology, North Hospital, University Hospital of Saint-Etienne, 42055 Saint-Etienne, France; (G.K.); (M.P.)
| | - Michel Peoc’h
- Pathology, North Hospital, University Hospital of Saint-Etienne, 42055 Saint-Etienne, France; (G.K.); (M.P.)
| | - Marios E. Froudarakis
- Department of Pulmonology and Thoracic Oncology, North Hospital, University Hospital of Saint-Etienne, 42055 Saint-Etienne, France;
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26
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Opitz I, Scherpereel A, Berghmans T, Psallidas I, Glatzer M, Rigau D, Astoul P, Bölükbas S, Boyd J, Coolen J, De Bondt C, De Ruysscher D, Durieux V, Faivre-Finn C, Fennell DA, Galateau-Salle F, Greillier L, Hoda MA, Klepetko W, Lacourt A, McElnay P, Maskell NA, Mutti L, Pairon JC, Van Schil P, van Meerbeeck JP, Waller D, Weder W, Putora PM, Cardillo G. ERS/ESTS/EACTS/ESTRO guidelines for the management of malignant pleural mesothelioma. Eur J Cardiothorac Surg 2021; 58:1-24. [PMID: 32448904 DOI: 10.1093/ejcts/ezaa158] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
The European Respiratory Society (ERS)/European Society of Thoracic Surgeons (ESTS)/European Association for Cardio-Thoracic Surgery (EACTS)/European Society for Radiotherapy and Oncology (ESTRO) task force brought together experts to update previous 2009 ERS/ESTS guidelines on management of malignant pleural mesothelioma (MPM), a rare cancer with globally poor outcome, after a systematic review of the 2009-2018 literature. The evidence was appraised using the Grading of Recommendations, Assessment, Development and Evaluation approach. The evidence syntheses were discussed and recommendations formulated by this multidisciplinary group of experts. Diagnosis: pleural biopsies remain the gold standard to confirm the diagnosis, usually obtained by thoracoscopy but occasionally via image-guided percutaneous needle biopsy in cases of pleural symphysis or poor performance status. Pathology: standard staining procedures are insufficient in ∼10% of cases, justifying the use of specific markers, including BAP-1 and CDKN2A (p16) for the separation of atypical mesothelial proliferation from MPM. Staging: in the absence of a uniform, robust and validated staging system, we advise using the most recent 2016 8th TNM (tumour, node, metastasis) classification, with an algorithm for pretherapeutic assessment. Monitoring: patient's performance status, histological subtype and tumour volume are the main prognostic factors of clinical importance in routine MPM management. Other potential parameters should be recorded at baseline and reported in clinical trials. Treatment: (chemo)therapy has limited efficacy in MPM patients and only selected patients are candidates for radical surgery. New promising targeted therapies, immunotherapies and strategies have been reviewed. Because of limited data on the best combination treatment, we emphasize that patients who are considered candidates for a multimodal approach, including radical surgery, should be treated as part of clinical trials in MPM-dedicated centres.
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Affiliation(s)
- Isabelle Opitz
- Department of Thoracic Surgery, University Hospital Zurich, Zurich, Switzerland
| | - Arnaud Scherpereel
- Department of Pulmonary and Thoracic Oncology, French National Network of Clinical Expert Centers for Malignant Pleural Mesothelioma Management (Mesoclin), Lille, France.,Department of Pulmonary and Thoracic Oncology, University Lille, CHU Lille, INSERM U1189, OncoThAI, Lille, France
| | | | - Ioannis Psallidas
- Oxford Centre for Respiratory Medicine, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Markus Glatzer
- Department of Radiation Oncology, Kantonsspital St. Gallen, St. Gallen, Switzerland
| | - David Rigau
- Iberoamerican Cochrane Center, Barcelona, Spain
| | - Philippe Astoul
- Department of Thoracic Oncology, Pleural Diseases and Interventional Pulmonology, Hôpital Nord, Aix-Marseille University, Marseille, France
| | - Servet Bölükbas
- Department of Thoracic Surgery, Evang, Kliniken Essen-Mitte, Essen, Germany
| | | | - Johan Coolen
- Department of Imaging and Pathology, KU Leuven, Leuven, Belgium
| | - Charlotte De Bondt
- Department of Pulmonology and Thoracic Oncology, Antwerp University and Antwerp University Hospital, Antwerp, Belgium
| | - Dirk De Ruysscher
- Department of Radiation Oncology (Maastro Clinic), Maastricht University Medical Center+, GROW Research Institute, Maastricht, Netherlands
| | - Valerie Durieux
- Bibliothèque des Sciences de la Santé, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Corinne Faivre-Finn
- The Christie NHS Foundation Trust, The University of Manchester, Manchester, UK
| | - Dean A Fennell
- Leicester Cancer Research Centre, University of Leicester and University of Leicester Hospitals NHS Trust, Leicester, UK
| | - Francoise Galateau-Salle
- Department of Biopathology, National Reference Center for Pleural Malignant Mesothelioma and Rare Peritoneal Tumors MESOPATH, Centre Leon Berard, Lyon, France
| | - Laurent Greillier
- Department of Multidisciplinary Oncology and Therapeutic Innovations, Aix Marseille University, Assistance Publique Hôpitaux de Marseille, Inserm UMR1068, CNRS UMR7258, Marseille, France
| | - Mir Ali Hoda
- Department of Thoracic Surgery, Medical University of Vienna, Vienna, Austria
| | - Walter Klepetko
- Department of Thoracic Surgery, Medical University of Vienna, Vienna, Austria
| | - Aude Lacourt
- University Bordeaux, INSERM, Bordeaux Population Health Research Center, Team EPICENE, UMR 1219, Bordeaux, France
| | | | - Nick A Maskell
- Academic Respiratory Unit, Bristol Medical School, University of Bristol, Bristol, UK
| | - Luciano Mutti
- Teaching Hospital Vercelli/Gruppo Italiano, Vercelli, Italy
| | - Jean-Claude Pairon
- INSERM U955, GEIC2O, Université Paris-Est Créteil, Service de Pathologies professionnelles et de l'Environnement, Institut Santé -Travail Paris-Est, CHI Créteil, Créteil, France
| | - Paul Van Schil
- Department of Thoracic and Vascular Surgery, Antwerp University and Antwerp University Hospital, Antwerp, Belgium
| | - Jan P van Meerbeeck
- Department of Pulmonology and Thoracic Oncology, Antwerp University and Antwerp University Hospital, Antwerp, Belgium
| | - David Waller
- Barts Thorax Centre, St Bartholomew's Hospital, London, UK
| | - Walter Weder
- Department of Thoracic Surgery, University Hospital Zurich, Zurich, Switzerland
| | - Paul Martin Putora
- Department of Radiation Oncology, Kantonsspital St. Gallen, St. Gallen, Switzerland.,Department of Radiation Oncology, University of Bern, Bern, Switzerland
| | - Giuseppe Cardillo
- Unit of Thoracic Surgery, Azienda Ospedaliera San Camillo Forlanini, Rome, Italy
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27
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Future Incidence of Malignant Mesothelioma in South Korea: Updated Projection to 2038. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18126614. [PMID: 34205400 PMCID: PMC8296497 DOI: 10.3390/ijerph18126614] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Revised: 06/10/2021] [Accepted: 06/13/2021] [Indexed: 11/23/2022]
Abstract
Malignant mesothelioma (MM) is a cancer that is largely caused by exposure to asbestos. Although asbestos is no longer used in South Korea, the incidence of MM continues to increase due to its long latent period. We aimed to update the previous prediction of MM incidence until 2038. We predicted the incidence of MM over the next 20 years (2019–2038) in South Korea using Møller’s age–period–cohort (APC) model and a Poisson regression model based on asbestos consumption. The APC model predicted that the crude incidence rate would increase sharply in men and slowly in women. Despite the sex discrepancy in the rate of increase, the incidence rate for both sexes is expected to continue increasing until 2038. In the Poisson model, the crude incidence rate was predicted to increase continuously until 2038, and far more cases of MM were predicted to occur compared with the results of the APC model. When compared with actual incidence data, the APC model was deemed more suitable than the Poisson model. The APC model predicted a continuous increase over the next 20 years with no peak, suggesting that the incidence of MM will continue to rise far into the future.
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28
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Schumann SO, Kocher G, Minervini F. Epidemiology, diagnosis and treatment of the malignant pleural mesothelioma, a narrative review of literature. J Thorac Dis 2021; 13:2510-2523. [PMID: 34012597 PMCID: PMC8107529 DOI: 10.21037/jtd-20-2761] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
The malignant pleural mesothelioma is a very aggressive tumor which is arising from mesothelial cells and is associated with asbestos exposure. It is a heterogeneous cancer that shows a complex pattern of molecular changes, including genetic, chromosomic, and epigenetic abnormalities. The malignant pleural mesothelioma is characterized by a silent and slow clinical progression with an average period of 20–40 years from the asbestos exposure phase to the start of the symptoms. Unfortunately, to date, the therapeutic options are very limited, especially if the tumor is detected late. This narrative review provides an extended overview of the present evidence in the literature regarding the epidemiology, diagnostic pathways and treatment approaches of the malignant pleural mesothelioma. The treatment of mesothelioma has evolved slowly over the last 20 years not only from a surgical point of view but also radiotherapy, chemotherapy and immunotherapy play nowadays a key role. Several surgical strategies are available ranging from extrapleural pneumonectomy to cytoreductive surgery but a multidisciplinary approach seems to be mandatory because a single approach has not proved to date to be resolutive. New non-surgical treatment options appear to be promising but the results have to be taken in account with caution because clear evidence with high-quality studies is still lacking
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Affiliation(s)
| | - Gregor Kocher
- Division of General Thoracic Surgery, Inselspital, Bern University Hospital, University of Bern, Switzerland
| | - Fabrizio Minervini
- Department of Thoracic Surgery, Lucerne Cantonal Hospital, Lucerne, Switzerland
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29
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Arachi D, Furuya S, David A, Mangwiro A, Chimed-Ochir O, Lee K, Tighe P, Takala J, Driscoll T, Takahashi K. Development of the "National Asbestos Profile" to Eliminate Asbestos-Related Diseases in 195 Countries. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18041804. [PMID: 33673264 PMCID: PMC7917934 DOI: 10.3390/ijerph18041804] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 02/07/2021] [Accepted: 02/08/2021] [Indexed: 12/20/2022]
Abstract
Worldwide, 230,000+ people die annually from asbestos-related diseases (ARDs). The World Health Organization (WHO) recommends that countries develop a National Asbestos Profile (NAP) to eliminate ARDs. For 195 countries, we assessed the global status of NAPs (A: bona fide NAP, B: proxy NAP, C: relevant published information, D: no relevant information) by national income (HI: high, UMI: upper-middle, LMI: lower-middle, LI: low), asbestos bans (banned, no-ban) and public data availability. Fourteen (7% of 195) countries were category A (having a bona fide NAP), while 98, 51 and 32 countries were categories B, C and D, respectively. Of the 14 category-A countries, 8, 3 and 3 were LMI, UMI and HI, respectively. Development of a bona fide NAP showed no gradient by national income. The proportions of countries having a bona fide NAP were similar between asbestos-banned and no-ban countries. Public databases useful for developing NAPs contained data for most countries. Irrespective of the status of national income or asbestos ban, most countries have not developed a NAP despite having the potential. The global status of NAP is suboptimal. Country-level data on asbestos and ARDs in public databases can be better utilized to develop NAPs for globally eliminating ARDs.
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Affiliation(s)
- Diana Arachi
- Asbestos Diseases Research Institute, Concord, NSW 2139, Australia;
| | - Sugio Furuya
- Japan Occupational Safety and Health Research Center, Tokyo 204-0024, Japan;
| | | | - Alexander Mangwiro
- Secretariat of the Basel, Rotterdam and Stockholm Conventions, United Nations Environment Program, 1219 Geneva, Switzerland;
| | - Odgerel Chimed-Ochir
- Asbestos Diseases Research Institute, Concord, NSW 2139, Australia;
- Department of Environmental Epidemiology, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Kitakyushu 807-8555, Japan;
| | - Kenneth Lee
- Asbestos Diseases Research Institute, Concord, NSW 2139, Australia;
- Department of Anatomical Pathology, Concord Repatriation General Hospital, Concord, NSW 2139, Australia;
| | - Peter Tighe
- Asbestos Diseases Research Foundation, Concord, NSW 2139, Australia;
| | - Jukka Takala
- International Commission on Occupational Health, 20122 Milan, Italy;
| | - Tim Driscoll
- School of Public Health, The University of Sydney, Sydney, NSW 2006, Australia;
| | - Ken Takahashi
- Asbestos Diseases Research Institute, Concord, NSW 2139, Australia;
- University of Occupational and Environmental Health, Kitakyushu 807-8555, Japan
- Correspondence:
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Meng YQ, Shi Q, Zhu SJ, He GH, Zhang SJ, Sun C. Asbestos-Induced Lung Cancer-Associated SNP rs13383928 Regulates PTH2R Expression in Lung Tissue. Hum Hered 2021; 85:1-5. [PMID: 33550301 DOI: 10.1159/000513291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 11/19/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Lung cancer is one of the most common malignant tumors, and asbestos exposure was suggested to contribute to a proportion of lung cancer cases. Previous genome-wide gene-environment interaction analysis reported that rs13383928 was associated with asbestos-related lung cancer. However, the mechanism of this association was still unclear. METHODS In the present study, we retrieved the genotype data from the 1,000 Genomes Project on single-nucleotide polymorphisms (SNPs) surrounding rs13383928 and analyzed the linkage disequilibrium (LD) pattern of this region. Further functional genomics analyses were performed. RESULTS The result indicated that no other SNPs were in LD with rs13383928, suggesting that rs13383928 is the causal one. The following dual luciferase assay disclosed that the T allele of rs13383928 presented significantly higher enhancer activity than G in lung cells, thus verifying that this SNP was functional in the lung. Through chromosome conformation capture, the PTH2R (parathyroid hormone 2 receptor)promoter was identified to interact with the segment surrounding rs13383928. By chromatin immunoprecipitation, it was observed that the region spanning rs13383928 could bind transcription factor FOXJ2 (forkhead box J2). CONCLUSION Our functional genomics evidence supports a link between rs13383928 and asbestos-related lung cancer through regulating PTH2R.
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Affiliation(s)
- Yuan-Qing Meng
- College of Life Sciences, Shaanxi Normal University, Xi'an, China
| | - Qiang Shi
- College of Life Sciences, Shaanxi Normal University, Xi'an, China
| | - Si-Jing Zhu
- College of Life Sciences, Shaanxi Normal University, Xi'an, China
| | - Guang-Huan He
- College of Life Sciences, Shaanxi Normal University, Xi'an, China
| | - Shi-Jiao Zhang
- College of Life Sciences, Shaanxi Normal University, Xi'an, China
| | - Chang Sun
- College of Life Sciences, Shaanxi Normal University, Xi'an, China,
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31
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Xu D, Yang H, Schmid RA, Peng RW. Therapeutic Landscape of Malignant Pleural Mesothelioma: Collateral Vulnerabilities and Evolutionary Dependencies in the Spotlight. Front Oncol 2020; 10:579464. [PMID: 33072611 PMCID: PMC7538645 DOI: 10.3389/fonc.2020.579464] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 09/02/2020] [Indexed: 12/21/2022] Open
Abstract
Malignant pleural mesothelioma (MPM) is the epitome of a recalcitrant cancer driven by pharmacologically intractable tumor suppressor proteins. A significant but largely unmet challenge in the field is the translation of genetic information on alterations in tumor suppressor genes (TSGs) into effective cancer-specific therapies. The notion that abnormal tumor genome subverts physiological cellular processes, which creates collateral vulnerabilities contextually related to specific genetic alterations, offers a promising strategy to target TSG-driven MPM. Moreover, emerging evidence has increasingly appreciated the therapeutic potential of genetic and pharmacological dependencies acquired en route to cancer development and drug resistance. Here, we review the most recent progress on vulnerabilities co-selected by functional loss of major TSGs and dependencies evolving out of cancer development and resistance to cisplatin based chemotherapy, the only first-line regimen approved by the US Food and Drug Administration (FDA). Finally, we highlight CRISPR-based functional genomics that has emerged as a powerful platform for cancer drug discovery in MPM. The repertoire of MPM-specific “Achilles heel” rises on the horizon, which holds the promise to elucidate therapeutic landscape and may promote precision oncology for MPM.
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Affiliation(s)
- Duo Xu
- Division of General Thoracic Surgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.,Department for BioMedical Research (DBMR), Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Haitang Yang
- Division of General Thoracic Surgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.,Department for BioMedical Research (DBMR), Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Ralph A Schmid
- Division of General Thoracic Surgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.,Department for BioMedical Research (DBMR), Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Ren-Wang Peng
- Division of General Thoracic Surgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.,Department for BioMedical Research (DBMR), Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
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Abstract
BACKGROUND Mesothelioma is a rare and deadly form of cancer, linked to asbestos exposure. Although the United Kingdom has banned asbestos, the incidence rate remains high. Previous research has indicated that female individuals have better survival than male individuals, but this has never been examined in the United Kingdom. MATERIALS AND METHODS Pleural mesothelioma cases from 2005 to 2014 were extracted from the United Kingdom Lung Cancer Dataset. Multivariable logistic regression was used to assess the clinical and demographic factors associated with gender. A multivariable Cox proportional hazards model and propensity matching methods were used to assess gender differences in overall survival while accounting for potential confounders. RESULTS There were 8479 (87.8%) male and 1765 (17.2%) female individuals included in the analysis. Female individuals were significantly younger, with more epithelial histology than male individuals. Female individuals had significantly better overall survival (adjusted hazard ratio, 0.85, 95% confidence interval, 0.81-0.90). Results remained similar when stratifying by age and performance status, and when limiting to patients with epithelial histology. CONCLUSIONS The study increases knowledge about gender differences in mesothelioma survival and is the first to directly examine this in the United Kingdom. It further disentangles the effects of age, histology, and health status. Increased estrogen may improve survival and could provide a potential target for future therapies.
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33
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Klampatsa A, Albelda SM. Current Advances in CAR T Cell Therapy for Malignant Mesothelioma. JOURNAL OF CELLULAR IMMUNOLOGY 2020; 2:192-200. [PMID: 32914147 PMCID: PMC7480947 DOI: 10.33696/immunology.2.042] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Malignant mesothelioma is a relatively rare malignancy arising in the body's serosal surfaces, with malignant pleural mesothelioma (MPM) being the most common type. It is characterized by local spread within the thorax, poor prognosis and resistance to treatment. The development of various immunotherapeutic options has provided a new way- and hope- in treating cancer patients. Chimeric antigen receptor (CAR) T cell therapy has been proven very successful in treating hematological cancers, like leukemias and lymphomas, and its use is now being tested in solid tumors. CARs that recognize and bind to a specific tumor-associated antigen on the tumor's cell surface, are engineered and transduced into T cells. Interaction of the CAR T cell with the tumor then results in T cell activation and subsequent tumor cell lysis. In this review, we provide a current update on our previous comprehensive study summarizing the CAR T cell preclinical studies and clinical trials in MM, and discuss the future perspectives of CAR T cell therapy in this disease.
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Affiliation(s)
- Astero Klampatsa
- Division of Cancer Therapeutics, The Institute of Cancer Research, London, UK
| | - Steven M Albelda
- Division of Pulmonary, Allergy and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Girardi P, Merler E, Ferrante D, Silvestri S, Chellini E, Angelini A, Luberto F, Fedeli U, Oddone E, Vicentini M, Barone-Adesi F, Cena T, Mirabelli D, Mangone L, Roncaglia F, Sala O, Menegozzo S, Pirastu R, Azzolina D, Tunesi S, Miligi L, Perticaroli P, Pettinari A, Cuccaro F, Nannavecchia AM, Bisceglia L, Marinaccio A, Pavone VLM, Magnani C. Factors Affecting Asbestosis Mortality Among Asbestos-Cement Workers in Italy. Ann Work Expo Health 2020; 64:622-635. [PMID: 32328661 DOI: 10.1093/annweh/wxaa037] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 03/10/2020] [Accepted: 03/19/2020] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES This study was performed with the aim of investigating the temporal patterns and determinants associated with mortality from asbestosis among 21 cohorts of Asbestos-Cement (AC) workers who were heavily exposed to asbestos fibres. METHODS Mortality for asbestosis was analysed for a cohort of 13 076 Italian AC workers (18.1% women). Individual cumulative asbestos exposure index was calculated by factory and period of work weighting by the different composition of asbestos used (crocidolite, amosite, and chrysotile). Two different approaches to analysis, based on Standardized Mortality Ratios (SMRs) and Age-Period-Cohort (APC) models were applied. RESULTS Among the considered AC facilities, asbestos exposure was extremely high until the end of the 1970s and, due to the long latency, a peak of asbestosis mortality was observed after the 1990s. Mortality for asbestosis reached extremely high SMR values [SMR: males 508, 95% confidence interval (CI): 446-563; females 1027, 95% CI: 771-1336]. SMR increased steeply with the increasing values of cumulative asbestos exposure and with Time Since the First Exposure. APC analysis reported a clear age effect with a mortality peak at 75-80 years; the mortality for asbestosis increased in the last three quintiles of the cumulative exposure; calendar period did not have a significant temporal component while the cohort effect disappeared if we included in the model the cumulative exposure to asbestos. CONCLUSIONS Among heaviest exposed workers, mortality risk for asbestosis began to increase before 50 years of age. Mortality for asbestosis was mainly determined by cumulative exposure to asbestos.
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Affiliation(s)
- Paolo Girardi
- Mesothelioma Register of the Veneto Region, Regional Epidemiological System, Azienda Zero, Padua, Italy
| | - Enzo Merler
- Mesothelioma Register of the Veneto Region, Regional Epidemiological System, Azienda Zero, Padua, Italy
| | - Daniela Ferrante
- Unit of Medical Statistics and Cancer Epidemiology, Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy.,CPO-Piedmont, Novara, Italy
| | - Stefano Silvestri
- CPO-Piedmont, Novara, Italy.,Occupational Hygienists, Unit of Medical Statistics and Epidemiology, Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy
| | - Elisabetta Chellini
- Occupational & Environmental Epidemiology Unit-Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Florence, Italy
| | - Alessia Angelini
- Occupational & Environmental Epidemiology Unit-Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Florence, Italy
| | - Ferdinando Luberto
- Epidemiology Service, Azienda Unità Sanitaria Locale-IRCCS, Montecchio Emilia, Reggio Emilia, Italy
| | - Ugo Fedeli
- Mesothelioma Register of the Veneto Region, Regional Epidemiological System, Azienda Zero, Padua, Italy
| | - Enrico Oddone
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
| | - Massimo Vicentini
- Epidemiology Service, Azienda Unità Sanitaria Locale-IRCCS, Montecchio Emilia, Reggio Emilia, Italy
| | - Francesco Barone-Adesi
- CPO-Piedmont, Novara, Italy.,Department of 'Scienze del Farmaco', University of Eastern Piedmont, Novara, Italy
| | - Tiziana Cena
- Unit of Medical Statistics and Cancer Epidemiology, Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy.,CPO-Piedmont, Novara, Italy
| | - Dario Mirabelli
- Unit of Cancer Epidemiology, CPO Piedmont and University of Turin, Turin, Italy
| | - Lucia Mangone
- Epidemiology Service, Azienda Unità Sanitaria Locale-IRCCS, Montecchio Emilia, Reggio Emilia, Italy
| | - Francesca Roncaglia
- Epidemiology Service, Azienda Unità Sanitaria Locale-IRCCS, Montecchio Emilia, Reggio Emilia, Italy
| | - Orietta Sala
- Occupational Hygienist, Formerly: Regional Agency for Prevention, Environment and Energy Emilia-Romagna, Provincial Office of Reggio Emilia, Reggio Emilia, Italy
| | - Simona Menegozzo
- National Cancer Institute IRCCS Fondazione Pascale, Naples, Italy
| | - Roberta Pirastu
- Department of Biology and Biotechnologies 'Charles Darwin', Sapienza University, Rome, Italy
| | - Danila Azzolina
- Unit of Medical Statistics and Cancer Epidemiology, Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy.,CPO-Piedmont, Novara, Italy
| | - Sara Tunesi
- Unit of Medical Statistics and Cancer Epidemiology, Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy.,CPO-Piedmont, Novara, Italy.,Unit of Cancer Epidemiology, CPO Piedmont and University of Turin, Turin, Italy
| | - Lucia Miligi
- Occupational & Environmental Epidemiology Unit-Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Florence, Italy
| | | | - Aldo Pettinari
- Prevention Department, ASUR Marche, Senigallia, Ancona, Italy
| | - Francesco Cuccaro
- Unit of Epidemiology and Statistics-Local Health Unit of Barletta-Andria-Trani, Barletta, Italy
| | - Anna Maria Nannavecchia
- Unit of Epidemiology and Statistics-Local Health Unit of Barletta-Andria-Trani, Barletta, Italy
| | | | - Alessandro Marinaccio
- Italian Workers' Compensation Authority (INAIL), Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Unit of Occupational and Environmental Epidemiology, Italian Mesothelioma Register, Rome, Italy
| | - Venere Leda Mara Pavone
- Department of Public Health, Prevention and Security Area Work Environments, Local Health Authority, San Lazzaro di Savena, Italy
| | - Corrado Magnani
- Unit of Medical Statistics and Cancer Epidemiology, Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy.,CPO-Piedmont, Novara, Italy
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Scherpereel A, Opitz I, Berghmans T, Psallidas I, Glatzer M, Rigau D, Astoul P, Bölükbas S, Boyd J, Coolen J, De Bondt C, De Ruysscher D, Durieux V, Faivre-Finn C, Fennell D, Galateau-Salle F, Greillier L, Hoda MA, Klepetko W, Lacourt A, McElnay P, Maskell NA, Mutti L, Pairon JC, Van Schil P, van Meerbeeck JP, Waller D, Weder W, Cardillo G, Putora PM. ERS/ESTS/EACTS/ESTRO guidelines for the management of malignant pleural mesothelioma. Eur Respir J 2020; 55:13993003.00953-2019. [PMID: 32451346 DOI: 10.1183/13993003.00953-2019] [Citation(s) in RCA: 128] [Impact Index Per Article: 32.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2019] [Accepted: 10/17/2019] [Indexed: 12/23/2022]
Abstract
The European Respiratory Society (ERS)/European Society of Thoracic Surgeons (ESTS)/European Association for Cardio-Thoracic Surgery (EACTS)/European Society for Radiotherapy and Oncology (ESTRO) task force brought together experts to update previous 2009 ERS/ESTS guidelines on management of malignant pleural mesothelioma (MPM), a rare cancer with globally poor outcome, after a systematic review of the 2009-2018 literature. The evidence was appraised using the Grading of Recommendations, Assessment, Development and Evaluation approach. The evidence syntheses were discussed and recommendations formulated by this multidisciplinary group of experts. Diagnosis: pleural biopsies remain the gold standard to confirm the diagnosis, usually obtained by thoracoscopy but occasionally via image-guided percutaneous needle biopsy in cases of pleural symphysis or poor performance status. Pathology: standard staining procedures are insufficient in ∼10% of cases, justifying the use of specific markers, including BAP-1 and CDKN2A (p16) for the separation of atypical mesothelial proliferation from MPM. Staging: in the absence of a uniform, robust and validated staging system, we advise using the most recent 2016 8th TNM (tumour, node, metastasis) classification, with an algorithm for pre-therapeutic assessment. Monitoring: patient's performance status, histological subtype and tumour volume are the main prognostic factors of clinical importance in routine MPM management. Other potential parameters should be recorded at baseline and reported in clinical trials. Treatment: (chemo)therapy has limited efficacy in MPM patients and only selected patients are candidates for radical surgery. New promising targeted therapies, immunotherapies and strategies have been reviewed. Because of limited data on the best combination treatment, we emphasise that patients who are considered candidates for a multimodal approach, including radical surgery, should be treated as part of clinical trials in MPM-dedicated centres.
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Affiliation(s)
- Arnaud Scherpereel
- Pulmonary and Thoracic Oncology, Univ. Lille, CHU Lille, INSERM U1189, OncoThAI, Lille, France .,French National Network of Clinical Expert Centers for Malignant Pleural Mesothelioma Management (Mesoclin), Lille, France
| | - Isabelle Opitz
- Dept of Thoracic Surgery, University Hospital Zurich, Zurich, Switzerland
| | | | - Ioannis Psallidas
- Oxford Centre for Respiratory Medicine, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Markus Glatzer
- Dept of Radiation Oncology, Kantonsspital St Gallen, St Gallen, Switzerland
| | - David Rigau
- Iberoamerican Cochrane Center, Barcelona, Spain
| | - Philippe Astoul
- Dept of Thoracic Oncology, Pleural Diseases and Interventional Pulmonology, Hôpital Nord, Aix-Marseille University, Marseille, France
| | - Servet Bölükbas
- Dept of Thoracic Surgery, Evang, Kliniken Essen-Mitte, Essen, Germany
| | | | - Johan Coolen
- Dept of Imaging and Pathology, KU Leuven, Leuven, Belgium
| | - Charlotte De Bondt
- Dept of Pulmonology and Thoracic Oncology, Antwerp University and Antwerp University Hospital, Antwerp, Belgium
| | - Dirk De Ruysscher
- Dept of Radiation Oncology (Maastro Clinic), Maastricht University Medical Center+, GROW Research Institute, Maastricht, The Netherlands
| | - Valerie Durieux
- Bibliothèque des Sciences de la Santé, Université libre de Bruxelles (ULB), Brussels, Belgium
| | - Corinne Faivre-Finn
- The Christie NHS Foundation Trust, The University of Manchester, Manchester, UK
| | - Dean Fennell
- Leicester Cancer Research Centre, University of Leicester and University of Leicester Hospitals NHS Trust, Leicester, UK
| | - Francoise Galateau-Salle
- National Reference Center for Pleural Malignant Mesothelioma and Rare Peritoneal Tumors MESOPATH, Dept of Biopathology, Centre Leon Berard, Lyon, France
| | - Laurent Greillier
- Aix Marseille University, Assistance Publique Hôpitaux de Marseille, Inserm UMR1068, CNRS UMR7258, Dept of Multidisciplinary Oncology and Therapeutic Innovations, Marseille, France
| | - Mir Ali Hoda
- Dept of Thoracic Surgery, Medical University of Vienna, Vienna, Austria
| | - Walter Klepetko
- Dept of Thoracic Surgery, Medical University of Vienna, Vienna, Austria
| | - Aude Lacourt
- Univ. Bordeaux, INSERM, Bordeaux Population Health Research Center, team EPICENE, UMR 1219, Bordeaux, France
| | | | - Nick A Maskell
- Academic Respiratory Unit, Bristol Medical School, University of Bristol, Bristol, UK
| | - Luciano Mutti
- Teaching Hosp. Vercelli/Gruppo Italiano Mesotelioma, Italy
| | - Jean-Claude Pairon
- INSERM U955, Equipe 4, Université Paris-Est Créteil, and Service de Pathologies professionnelles et de l'Environnement, Institut Santé-Travail Paris-Est, CHI Créteil, Créteil, France
| | - Paul Van Schil
- Dept Thoracic and Vascular Surgery, Antwerp University and Antwerp University Hospital, Antwerp, Belgium
| | - Jan P van Meerbeeck
- Dept of Pulmonology and Thoracic Oncology, Antwerp University and Antwerp University Hospital, Antwerp, Belgium
| | - David Waller
- Barts Thorax Centre, St Bartholomew's Hospital, London, UK
| | - Walter Weder
- Dept of Thoracic Surgery, University Hospital Zurich, Zurich, Switzerland
| | - Giuseppe Cardillo
- Unit of Thoracic Surgery, Azienda Ospedaliera San Camillo Forlanini, Rome, Italy
| | - Paul Martin Putora
- Dept of Radiation Oncology, Kantonsspital St Gallen, St Gallen, Switzerland.,Dept of Radiation Oncology, University of Bern, Bern, Switzerland
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Metintas S, Ak G, Metintas M. Potential years of life and productivity loss due to malignant mesothelioma in Turkey. ARCHIVES OF ENVIRONMENTAL & OCCUPATIONAL HEALTH 2020; 75:464-470. [PMID: 32282287 DOI: 10.1080/19338244.2020.1747380] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The study aimed to calculate years of life lost (YLL) and years of potential life lost (YPLL) due to malignant mesothelioma (MM) in Turkey. YLL was computed by estimating the difference between age at death due to MM and the expected death age. To calculate YPLL, all deaths above 65 years (retirement age) were disregarded. Of the 5,617 deaths due to MM in the study period, 3,241 (57.70%) were male and 2,376 (42.30%) were female. The median YLL and YPLL were 16.58 and 25.13 for males and 19.83 and 28.50 years for females. YLL and YPLL were shorter in males than females (p < 0.001). Premature mortality cost per death was $ 45,963.57 (2.23 times higher for males). MM is associated with high YLL, YPLL and economic burden in a country with environmental asbestos exposure in the rural areas.
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Affiliation(s)
- Selma Metintas
- Lung and Pleural Cancers Research and Clinical Center, Eskisehir Osmangazi University, Eskisehir, Turkey
- Medical Faculty, Department of Public Health, Eskisehir Osmangazi University, Eskisehir, Turkey
| | - Guntulu Ak
- Lung and Pleural Cancers Research and Clinical Center, Eskisehir Osmangazi University, Eskisehir, Turkey
- Medical Faculty, Department of Chest Diseases, Eskisehir Osmangazi University, Eskisehir, Turkey
| | - Muzaffer Metintas
- Lung and Pleural Cancers Research and Clinical Center, Eskisehir Osmangazi University, Eskisehir, Turkey
- Medical Faculty, Department of Chest Diseases, Eskisehir Osmangazi University, Eskisehir, Turkey
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37
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van Zandwijk N, Reid G, Frank AL. Asbestos-related cancers: the 'Hidden Killer' remains a global threat. Expert Rev Anticancer Ther 2020; 20:271-278. [PMID: 32223452 DOI: 10.1080/14737140.2020.1745067] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Introduction: Asbestos, the most frequent cause of occupational cancer, continues to be consumed on a massive scale, with millions of people exposed on a daily basis. This review explains why we have failed in curtailing the silent epidemic of asbestos-related disease and why the numbers of asbestos victims are likely to remain high. Emerging and developed countries have to be reminded that asbestos exposure has yet to become a problem of the past. The worldwide spread of asbestos, followed by the surge of asbestos-related cancers, resembles the lung cancer epidemic caused by smoking and stimulated by manufacturers.Areas covered: Underreporting of malignant mesothelioma and asbestos-induced lung cancer, frequently-used arguments in the amphibole/chrysotile debate and the conclusion from bona-fide research organizations, that all forms of asbestos are carcinogenic, are reviewed. Special attention is paid to the consequences of ubiquitous environmental asbestos and the 'changing face' of malignant mesothelioma in countries with heavy asbestos use in the past.Expert opinion: Experts in oncology, respiratory medicine, occupational and public health, and basic researchers must take responsibility and acknowledge the ongoing silent epidemic of asbestos-related diseases. The call for a world-wide asbestos ban is more urgent than ever.
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Affiliation(s)
- Nico van Zandwijk
- Concord (Sydney) Medical School, University of Sydney, Concord Repatriation General Hospital, Concord, Australia
| | - Glen Reid
- Department of Pathology, University of Otago, Dunedin, New Zealand
| | - Arthur L Frank
- Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
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38
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Global and regional burden of cancer in 2016 arising from occupational exposure to selected carcinogens: a systematic analysis for the Global Burden of Disease Study 2016. Occup Environ Med 2020; 77:151-159. [PMID: 32054819 PMCID: PMC7035689 DOI: 10.1136/oemed-2019-106012] [Citation(s) in RCA: 59] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Revised: 12/03/2019] [Accepted: 12/06/2019] [Indexed: 02/07/2023]
Abstract
OBJECTIVES This study provides a detailed analysis of the global and regional burden of cancer due to occupational carcinogens from the Global Burden of Disease 2016 study. METHODS The burden of cancer due to 14 International Agency for Research on Cancer Group 1 occupational carcinogens was estimated using the population attributable fraction, based on past population exposure prevalence and relative risks from the literature. The results were used to calculate attributable deaths and disability-adjusted life years (DALYs). RESULTS There were an estimated 349 000 (95% Uncertainty Interval 269 000 to 427 000) deaths and 7.2 (5.8 to 8.6) million DALYs in 2016 due to exposure to the included occupational carcinogens-3.9% (3.2% to 4.6%) of all cancer deaths and 3.4% (2.7% to 4.0%) of all cancer DALYs; 79% of deaths were of males and 88% were of people aged 55 -79 years. Lung cancer accounted for 86% of the deaths, mesothelioma for 7.9% and laryngeal cancer for 2.1%. Asbestos was responsible for the largest number of deaths due to occupational carcinogens (63%); other important risk factors were secondhand smoke (14%), silica (14%) and diesel engine exhaust (5%). The highest mortality rates were in high-income regions, largely due to asbestos-related cancers, whereas in other regions cancer deaths from secondhand smoke, silica and diesel engine exhaust were more prominent. From 1990 to 2016, there was a decrease in the rate for deaths (-10%) and DALYs (-15%) due to exposure to occupational carcinogens. CONCLUSIONS Work-related carcinogens are responsible for considerable disease burden worldwide. The results provide guidance for prevention and control initiatives.
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Gerwen M, Alpert N, Flores R, Taioli E. An overview of existing mesothelioma registries worldwide, and the need for a US Registry. Am J Ind Med 2020; 63:115-120. [PMID: 31701555 DOI: 10.1002/ajim.23069] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 09/24/2019] [Accepted: 10/29/2019] [Indexed: 12/11/2022]
Abstract
The association between asbestos exposure, mainly in occupational settings, and malignant mesothelioma has been well established; this has prompted several countries to establish mesothelioma epidemiologic surveillance programs often at the request of national agencies. This review compares currently existing mesothelioma registries worldwide to develop a concept model for a US real-time case capture mesothelioma registry. Five countries were identified with a mesothelioma specific registry, including Italy, France, UK, Australia, and South Korea. All, except the UK, used interviews to collect exposure data. Linkage with the national death index was available or was in future plans for all registries. The registries have limited information on treatment, quality of life, and other patient-centered outcomes such as symptoms and pain management. To thoroughly collect exposure data, "real-time" enrollment is preferable; to maximize the capture of mesothelioma cases, optimal coverage, and a simplified consent process are needed.
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Affiliation(s)
- Maaike Gerwen
- Department of Population Health Science and Policy, Institute for Translational EpidemiologyIcahn School of Medicine at Mount SinaiNew York City New York
| | - Naomi Alpert
- Department of Population Health Science and Policy, Institute for Translational EpidemiologyIcahn School of Medicine at Mount SinaiNew York City New York
| | - Raja Flores
- Department of Thoracic SurgeryIcahn School of Medicine at Mount SinaiNew York City New York
| | - Emanuela Taioli
- Department of Population Health Science and Policy, Institute for Translational EpidemiologyIcahn School of Medicine at Mount SinaiNew York City New York
- Department of Thoracic SurgeryIcahn School of Medicine at Mount SinaiNew York City New York
- Tisch Cancer InstituteIcahn School of Medicine at Mount SinaiNew York City New York
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40
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Alpert N, van Gerwen M, Taioli E. Epidemiology of mesothelioma in the 21 st century in Europe and the United States, 40 years after restricted/banned asbestos use. Transl Lung Cancer Res 2020; 9:S28-S38. [PMID: 32206568 PMCID: PMC7082259 DOI: 10.21037/tlcr.2019.11.11] [Citation(s) in RCA: 65] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Research has established a strong association between asbestos exposure and malignant mesothelioma, a deadly form of cancer. Since the early 1980’s many countries have restricted or banned the production of asbestos, leading to a decline of occupational asbestos exposure in many industrialized countries. However, some countries continue to use asbestos, and worldwide rates of mesothelioma are still increasing. Because of the long latency between exposure and mesothelioma occurrence and the persistence of environmental exposure, incidence rates (IR) may decrease very slowly for several years ahead. In this review, we examine estimates of asbestos consumption before widespread asbestos regulations and the trends in incidence and mortality rates, as well as changes over time for the United States and Europe. In some countries with earlier asbestos restrictions, mesothelioma incidence has been in a modest decline over time. However, asbestos exposure is still a burden worldwide and legislative action is needed to obtain a full ban. The pattern of mesothelioma is shifting from a mostly male disease to a disease that affects females as well in substantial numbers. Studies on unknown sources of asbestos exposure, of other sources of natural exposure to asbestos and asbestos-like fibers, as well as of individual genetic susceptibility to asbestos fibers are needed.
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Affiliation(s)
- Naomi Alpert
- Institute for Translational Epidemiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Maaike van Gerwen
- Institute for Translational Epidemiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Emanuela Taioli
- Institute for Translational Epidemiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Department of Thoracic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Using a Mobile Phone App to Identify and Assess Remaining Stocks of In Situ Asbestos in Australian Residential Settings. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16244922. [PMID: 31817396 PMCID: PMC6950401 DOI: 10.3390/ijerph16244922] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 11/26/2019] [Accepted: 12/02/2019] [Indexed: 11/16/2022]
Abstract
Asbestos-containing materials (ACMs) were used extensively throughout much of the 20th century and can still be found in many Australian homes. Therefore, we developed a mobile application (“app”), called ACM Check, which guides users through a home inspection to identify and assess certain types of in situ ACM. A cross-sectional study was conducted using the app to collect data on the type and condition of in situ asbestos in Australian residential settings. Since being released in June 2017, we have received data for 702 home inspections. Of these, 578 (82.3%) houses contained a total of 1895 in situ materials categorised as positive for asbestos by the app. The most prevalent ACMs were used for the backing board to electrical meter boxes (50% of homes), eaves and soffit linings (44.2% of homes), and fencing (28.1% of homes). While the majority of ACMs were categorised as ‘very low’ or ‘low’ priority for removal or remediation, 6.6% of all ACMs were considered to be of ‘high’ priority. Mobile apps offer a platform to help increase people’s awareness of possible health hazards found in the residential environment, such as asbestos, while also being used to collect data for public and environmental health research.
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42
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Reynolds CJ, Minelli C, Darnton A, Cullinan P. Mesothelioma mortality in Great Britain: how much longer will dockyards dominate? Occup Environ Med 2019; 76:908-912. [PMID: 31662422 DOI: 10.1136/oemed-2019-105878] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Revised: 09/24/2019] [Accepted: 10/02/2019] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We aimed to investigate whether there has been a geographic shift in the distribution of mesothelioma deaths in Great Britain given the decline of shipbuilding and progressive exposure regulation. METHODS We calculated age-adjusted mesothelioma mortality rates and estimated rate ratios for areas with and without a dockyard. We compared spatial autocorrelation statistics (Moran's I) for age-adjusted rates at local authority district level for 2002-2008 and 2009-2015. We measured the mean distance of the deceased's postcode to the nearest dockyard at district level and calculated the association of average distance to dockyard and district mesothelioma mortality using simple linear regression for men, for 2002-2008 and 2009-2015. RESULTS District age-adjusted male mortality rates fell during 2002-2015 for 80 of 348 districts (23%), rose for 267 (77%) and were unchanged for one district; having one or more dockyards in a district was associated with rates falling (OR=2.43, 95% CI 1.22 to 4.82, p=0.02). The mortality rate ratio for men in districts with a dockyard, compared with those without a dockyard was 1.41 (95% CI 1.35 to 1.48, p<0.05) for 2002-2008 and 1.18 (95% CI 1.13 to 1.23, p<0.05) for 2009-2015. Spatial autocorrelation (measured by Moran's I) decreased from 0.317 (95% CI 0.316 to 0.319, p=0.001) to 0.312 (95% CI 0.310 to 0.314, p=0.001) for men and the coefficient of the association between distance to dockyard and district level age-adjusted male mortality (per million population) from -0.16 (95% CI -0.21 to -0.10, p<0.01) to -0.13 (95% CI -0.18 to -0.07, p<0.01) for men, when comparing 2002-2008 with 2009-2015. CONCLUSION For most districts age-adjusted mesothelioma mortality rates increased through 2002-2015 but the relative contribution from districts with a dockyard fell. Dockyards remain strongly spatially associated with mesothelioma mortality but the strength of this association appears to be falling and mesothelioma deaths are becoming more dispersed.
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Affiliation(s)
- Carl J Reynolds
- National Heart & Lung Institute, Imperial College London, London, UK
| | - Cosetta Minelli
- National Heart & Lung Institute, Imperial College London, London, UK
| | - Andrew Darnton
- Health and Safety Executive Bootle Headquarters, Bootle, UK
| | - Paul Cullinan
- National Heart & Lung Institute, Imperial College London, London, UK
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Abstract
Since 1973 the International Agency for Research on Cancer has classified asbestos as a certain carcinogen, but today it is still used in several countries. To date, mesothelioma risk is certainly linked not only to occupational exposures but also to environmental exposures. The incidence and mortality are increasing worldwide, especially in developing countries where asbestos is still often used without adequate measures for worker safety. The epidemiological surveillance systems of related asbestos diseases are instruments of public health adopted internationally. The experience and the operating methodology of the Italian mesothelioma registry and the data produced from 1996 to 2015 highlight how in countries where the asbestos ban has been active for over 20 years the risk of asbestos remains present, especially in the construction sector as well as for the environmental exposures of the resident population near companies that used asbestos in their production cycle. Worldwide, it is necessary to introduce the ban on the extraction, processing, and marketing of asbestos as claimed by the international scientific community.
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44
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Gilham C, Rake C, Hodgson J, Darnton A, Burdett G, Peto Wild J, Newton M, Nicholson AG, Davidson L, Shires M, Treasure T, Peto J. Past and current asbestos exposure and future mesothelioma risks in Britain: The Inhaled Particles Study (TIPS). Int J Epidemiol 2019. [PMID: 29534192 PMCID: PMC6280925 DOI: 10.1093/ije/dyx276] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Background Occupational and environmental airborne asbestos concentrations are too low and variable for lifetime exposures to be estimated reliably, and building workers and occupants may suffer higher exposure when asbestos in older buildings is disturbed or removed. Mesothelioma risks from current asbestos exposures are therefore not known. Methods We interviewed and measured asbestos levels in lung samples from 257 patients treated for pneumothorax and 262 with resected lung cancer, recruited in England and Wales. Average lung burdens in British birth cohorts from 1940 to 1992 were estimated for asbestos-exposed workers and the general population. Results Regression analysis of British mesothelioma death rates and average lung burdens in birth cohorts born before 1965 suggests a lifetime mesothelioma risk of approximately 0.01% per fibre/mg of amphiboles in the lung. In those born since 1965, the average lung burden is ∼1 fibre/mg among those with no occupational exposure. Conclusions The average lifetime mesothelioma risk caused by recent environmental asbestos exposure in Britain will be about 1 in 10 000. The risk is an order of magnitude higher in a subgroup of exposed workers and probably in occupants in the most contaminated buildings. Further data are needed to discover whether asbestos still present in buildings, particularly schools, is a persistent or decreasing hazard to workers who disturb it and to the general population, and whether environmental exposure occurs predominantly in childhood or after beginning work. Similar studies are needed in other countries to estimate continuing environmental and occupational mesothelioma hazards worldwide, including the contribution from chrysotile.
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Affiliation(s)
- Clare Gilham
- London School of Hygiene and Tropical Medicine, London, UK
| | - Christine Rake
- London School of Hygiene and Tropical Medicine, London, UK
| | | | | | | | | | - Michelle Newton
- Department of Cardiovascular Sciences, University of Leicester, UK
| | - Andrew G Nicholson
- Department of Histopathology, Royal Brompton and Harefield Hospitals NHS Foundation Trust, and National Heart and Lung Institute, Imperial College, London, UK
| | - Leslie Davidson
- Department of Cellular Pathology, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Mike Shires
- Leeds Institute of Cancer and Pathology, University of Leeds, UK
| | - Tom Treasure
- Clinical Operational Research Unit, University College Hospital, London, UK
| | - Julian Peto
- London School of Hygiene and Tropical Medicine, London, UK
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45
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Sottile R, Tannazi M, Johansson MH, Cristiani CM, Calabró L, Ventura V, Cutaia O, Chiarucci C, Covre A, Garofalo C, Pontén V, Tallerico R, Frumento P, Micke P, Maio M, Kärre K, Carbone E. NK- and T-cell subsets in malignant mesothelioma patients: Baseline pattern and changes in the context of anti-CTLA-4 therapy. Int J Cancer 2019; 145:2238-2248. [PMID: 31018250 DOI: 10.1002/ijc.32363] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Accepted: 04/08/2019] [Indexed: 01/27/2023]
Abstract
Malignant mesothelioma (MM) is a highly aggressive form of cancer with limited treatment options. Although the role of NK cells has been studied in many solid tumors, the pattern of NK-cell subsets and their recognition of mesothelioma cells remain to be explored. We used RNA expression data of MM biopsies derived from the cancer genome atlas to evaluate the immune cell infiltrates. We characterized the phenotype of circulating NK and T cells of 27 MM patients before and after treatment with an anti-CTLA-4 antibody (tremelimumab). These immune cell profiles were compared to healthy controls. The RNA expression data of the MM biopsies indicated the presence of NK cells in a subgroup of patients. We demonstrated that NK cells recognize MM cell lines and that IL-15 stimulation improved NK cell-mediated lysis in vitro. Using multivariate projection models, we found that MM patients had a perturbed ratio of CD56bright and CD56dim NK subsets and increased serum concentrations of the cytokines IL-10, IL-8 and TNF-α. After tremelimumab treatment, the ratio between the CD56bright and CD56dim subsets shifted back towards physiological levels. Furthermore, the improved overall survival was correlated with low TIM-3+ CD8+ T-cell frequency, high DNAM-1+ CD56dim NK-cell frequency and high expression levels of NKp46 on the CD56dim NK cells before and after immune checkpoint blockade. Together, our observations suggest that NK cells infiltrate MM and that they can recognize and kill mesothelioma cells. The disease is associated with distinct lymphocytes patterns, some of which correlate with prognosis or are affected by treatment with tremelimumab.
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Affiliation(s)
- Rosa Sottile
- Department of Microbiology, Tumor and Cell Biology (MTC), Karolinska Institutet, Stockholm, Sweden
| | - Milad Tannazi
- Department of Pharmaceutical Science, Faculty of Science, Utrecht University, Utrecht, Netherlands
| | - Maria H Johansson
- Department of Microbiology, Tumor and Cell Biology (MTC), Karolinska Institutet, Stockholm, Sweden
| | - Costanza Maria Cristiani
- Tumor Immunology and Immunopathology Laboratory, Department of Experimental and Clinical Medicine, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - Luana Calabró
- Center for Immuno-Oncology, Medical Oncology and Immunotherapy, University Hospital of Siena, Siena, Italy
| | - Valeria Ventura
- Tumor Immunology and Immunopathology Laboratory, Department of Experimental and Clinical Medicine, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - Ornella Cutaia
- Center for Immuno-Oncology, Medical Oncology and Immunotherapy, University Hospital of Siena, Siena, Italy
| | - Carla Chiarucci
- Center for Immuno-Oncology, Medical Oncology and Immunotherapy, University Hospital of Siena, Siena, Italy
| | - Alessia Covre
- Center for Immuno-Oncology, Medical Oncology and Immunotherapy, University Hospital of Siena, Siena, Italy
| | - Cinzia Garofalo
- Tumor Immunology and Immunopathology Laboratory, Department of Experimental and Clinical Medicine, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - Victor Pontén
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala University Hospital, Uppsala, Sweden
| | - Rossana Tallerico
- Tumor Immunology and Immunopathology Laboratory, Department of Experimental and Clinical Medicine, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - Paolo Frumento
- Institute of Environmental Medicine, Unit of Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Patrick Micke
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala University Hospital, Uppsala, Sweden
| | - Michele Maio
- Center for Immuno-Oncology, Medical Oncology and Immunotherapy, University Hospital of Siena, Siena, Italy
| | - Klas Kärre
- Department of Microbiology, Tumor and Cell Biology (MTC), Karolinska Institutet, Stockholm, Sweden
| | - Ennio Carbone
- Department of Microbiology, Tumor and Cell Biology (MTC), Karolinska Institutet, Stockholm, Sweden.,Tumor Immunology and Immunopathology Laboratory, Department of Experimental and Clinical Medicine, University Magna Graecia of Catanzaro, Catanzaro, Italy
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Yoneda K, Kuwata T, Chikaishi Y, Mori M, Kanayama M, Takenaka M, Oka S, Hirai A, Imanishi N, Kuroda K, Ichiki Y, Ohnaga T, Tanaka F. Detection of circulating tumor cells with a novel microfluidic system in malignant pleural mesothelioma. Cancer Sci 2019; 110:726-733. [PMID: 30499156 PMCID: PMC6361567 DOI: 10.1111/cas.13895] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Revised: 11/18/2018] [Accepted: 11/19/2018] [Indexed: 12/25/2022] Open
Abstract
Detection of rare tumor cells circulating in the blood (CTCs) presents technical challenges. CellSearch, the only approved system for clinical use, fails to capture epithelial cell adhesion molecule‐negative CTCs such as malignant pleural mesothelioma (MPM). We have developed a novel microfluidic device (CTC‐chip) in which any Ab to capture CTCs is conjugated. The CTC‐chip was coated with an Ab against podoplanin that is abundantly expressed on MPM. Circulating tumor cell‐detection performance was evaluated in experimental models in which MPM cells were spiked in blood sampled from a healthy volunteer and in clinical samples drawn from MPM patients. The CTC‐chip showed superior CTC‐detection performance over CellSearch in experimental models (sensitivity, 63.3%‐64.5% vs 0%‐1.1%; P < .001) and in clinical samples (CTC‐positivity, 68.8% vs 6.3%; P < .001). A receiver operating characteristic (ROC) analysis showed that the CTC test provided a significant diagnostic performance in discrimination of unresectable disease from resectable disease (area under the ROC curve, 0.851; P = .003). The higher CTC count (≥2 cells/mL) was significantly associated with a poor prognosis (P = .030). The novel CTC‐chip enabled sensitive detection of CTCs, which provided significant diagnostic and prognostic information in MPM.
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Affiliation(s)
- Kazue Yoneda
- Second Department of Surgery (Chest Surgery), University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Taiji Kuwata
- Second Department of Surgery (Chest Surgery), University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Yasuhiro Chikaishi
- Second Department of Surgery (Chest Surgery), University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Masataka Mori
- Second Department of Surgery (Chest Surgery), University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Masatoshi Kanayama
- Second Department of Surgery (Chest Surgery), University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Masaru Takenaka
- Second Department of Surgery (Chest Surgery), University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Soichi Oka
- Second Department of Surgery (Chest Surgery), University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Ayako Hirai
- Second Department of Surgery (Chest Surgery), University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Naoko Imanishi
- Second Department of Surgery (Chest Surgery), University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Koji Kuroda
- Second Department of Surgery (Chest Surgery), University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Yoshinobu Ichiki
- Second Department of Surgery (Chest Surgery), University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Takashi Ohnaga
- Central Research Laboratories, Toyama Industrial Technology Center, Takaoka, Japan
| | - Fumihiro Tanaka
- Second Department of Surgery (Chest Surgery), University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
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Jadhav AV, Gawde NC. Current Asbestos Exposure and Future Need for Palliative Care in India. Indian J Palliat Care 2019; 25:587-591. [PMID: 31673217 PMCID: PMC6812430 DOI: 10.4103/ijpc.ijpc_51_19] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Asbestos-related diseases (ARDs) are incurable but entirely preventable. Due to India's continuing use of asbestos, ARD patients will increase to a high number in the next three to four decades. This will increase the burden on palliative care system which is in nascent stage presently. Palliative care is the mainstay of the management of ARDs. Unfortunately, the burden on palliative care is likely to increase due to multiple factors contributed by India's demographic and economic changes. In the near future, there will be at least 12.5 million ARD patients and 1.25 million asbestos-related cancer patients worldwide, and half of these will be in India. It is high time to introspect about our ability to engage with this future problem. The paper also discusses the organization of this future problem of ARDs and possible action points toward future access to palliative care for ARD patients.
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Affiliation(s)
- Abhijeet Vasant Jadhav
- Centre for Public Health, School of Health Systems Studies, Tata Institute of Social Sciences, Vikas Anvesh Foundation, Pune, Maharashtra, India
| | - Nilesh C Gawde
- Centre for Public Health, School of Health Systems Studies, Tata Institute of Social Sciences, Vikas Anvesh Foundation, Pune, Maharashtra, India
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48
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Lee LJH, Lin CK, Pan CH, Cheng Y, Chang YY, Liou SH, Wang JD. Clustering of malignant pleural mesothelioma in asbestos factories: a subgroup analysis in a 29-year follow-up study to identify high-risk industries in Taiwan. BMJ Open 2018; 8:e021063. [PMID: 30530573 PMCID: PMC6303649 DOI: 10.1136/bmjopen-2017-021063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE Exposure to asbestos is the major cause for malignant pleural mesothelioma (MPM), but the causal link of individual cases is difficult to establish for lack of exposure information and long disease latency. METHODS We established a retrospective cohort of workers employed in asbestos industries during the period of 1950-1989 and the occurrence of MPM during the period of 1980-2009 was examined with the Taiwan Cancer Registry. Estimated rate ratios (eRRs) were computed for each factory where any case of MPM was diagnosed by assuming Poisson distribution with a minimal latency of 20 years. RESULTS A total of 18 MPM (17 males, 1 female) in eight factories were found. The incidence rate of MPM for the eight factories was 18.0 per million, ranging from 6.2 per million (military factory) to 268.2 per million (asbestos cement). We observed significantly increased risks for MPM in asbestos cement, thermal insulation and shipbuilding industries, with eRR (genders combined) of 113.6, 87.5 and 15.8, respectively. The sensitivity analyses considering latency showed similar findings in latency ≥30 years, and the shipbuilding industry presented a significant eRR given a latency ≥40 years. The gender-specific eRR showed similar results in men, but high eRR of 729.6 was observed in an asbestos cement factory where a female MPM was diagnosed. CONCLUSIONS This nationwide study in Taiwan comprehensively shows that different asbestos manufacturing processes, including asbestos cement, thermal insulation and shipbuilding industries, were at significantly increased risks for MPM. We recommend to establish a medical screening programme for workers previously exposed to asbestos to identify MPM and other asbestos-related diseases at an earlier stage.
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Affiliation(s)
- Lukas Jyuhn-Hsiarn Lee
- National Institute of Environmental Health Sciences, National Health Research Institutes, Zhunan, Taiwan
- Department of Environmental and Occupational Medicine, National Taiwan University Hospital, Taipei, Taiwan
- Institute of Occupational Medicine and Industrial Hygiene, College of Public Health, National Taiwan University, Taipei, Taiwan
- Ph.D. Program in Environmental and Occupational Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Cheng-Kuan Lin
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Chih-Hong Pan
- Institute of Labor, Occupational Safety and Health, Ministry of Labor, New Taipei City, Taiwan
- School of Public Health, National Defense Medical Center, Taipei, Taiwan
| | - Yawen Cheng
- Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Yu-Yin Chang
- National Institute of Environmental Health Sciences, National Health Research Institutes, Zhunan, Taiwan
| | - Saou-Hsing Liou
- National Institute of Environmental Health Sciences, National Health Research Institutes, Zhunan, Taiwan
| | - Jung-Der Wang
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Departments of Internal Medicine and Occupational and Environmental Medicine, National Cheng Kung University Hospital, Tainan, Taiwan
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49
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Nuyts V, Nawrot T, Nemery B, Nackaerts K. Hotspots of malignant pleural mesothelioma in Western Europe. Transl Lung Cancer Res 2018; 7:516-519. [PMID: 30450289 DOI: 10.21037/tlcr.2018.10.01] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Malignant pleural mesothelioma, a highly invasive tumour, has been epidemiologically linked to an occupational or environmental exposure to asbestos. Although asbestos has been widely used in diverse industrial applications and in construction, some industrial sectors have been affected much more than others. The objective of this review was to describe the existence of clusters of malignant pleural mesothelioma in Western European countries, based on epidemiological studies published between 2000 and 2015. MEDLINE (PubMed) and Embase were searched for relevant studies on spatial clustering of mesothelioma in Western European countries. Eventually, 16 different studies published between 2000 and 2015 were selected for a comprehensive analysis. Relevant studies on spatial clustering of mesothelioma were found for Belgium, the Netherlands, the United Kingdom, Germany, France, Spain, Italy and Denmark. Clustering of pleural mesothelioma was found mainly around shipyards (16 studies) and asbestos cement industries (10 studies). Although malignant pleural mesothelioma may be found throughout Western Europe, the present study indicates specific areas with higher past and also probable future incidence.
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Affiliation(s)
- Valerie Nuyts
- Department of Public Health and Primary Care, Centre for Environment and Health, KU Leuven, Leuven, Belgium
| | - Tim Nawrot
- Department of Public Health and Primary Care, Centre for Environment and Health, KU Leuven, Leuven, Belgium.,Centre for Environmental Sciences, University of Hasselt, Hasselt, Belgium
| | - Benoit Nemery
- Department of Public Health and Primary Care, Centre for Environment and Health, KU Leuven, Leuven, Belgium.,Department of Respiratory Diseases, University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - Kristiaan Nackaerts
- Department of Respiratory Diseases, University Hospitals Leuven, KU Leuven, Leuven, Belgium
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50
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Lin RT, Chang YY, Wang JD, Lee LJH. Upcoming epidemic of asbestos-related malignant pleural mesothelioma in Taiwan: A prediction of incidence in the next 30 years. J Formos Med Assoc 2018; 118:463-470. [PMID: 30072200 DOI: 10.1016/j.jfma.2018.07.013] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Revised: 06/26/2018] [Accepted: 07/11/2018] [Indexed: 10/28/2022] Open
Abstract
BACKGROUND/PURPOSE Globally, asbestos-related diseases (ARDs) keep rising over the coming decades. The epidemic of ARDs will be a burden on public health. We aimed to predict the malignant pleural mesothelioma (MPM) incidence in the next 30 years for Taiwan based on historical asbestos consumption. METHODS We collected annual data on local asbestos consumption during 1939-2015 and sex-specific incidence of pleural cancer as a proxy for MPM during 1979-2013. We applied Poisson log-linear models to predict future MPM numbers under the assumption that latency periods between asbestos exposure and MPM incidence were between 25 and 45 years. RESULTS Asbestos consumption reached a peak in the 1980s, with a total of 668 thousand metric tons during 1939-2015. The observed number of MPM incidence increased by 9- and 6-fold in males and females during 1979-2013, with a cumulative number of 907. Given a latency period of 31 years, MPM incidences were expected to peak around 2012-2016 for males and 2016-2020 for females. In 2017-2046, the predicted total number of new MPM might reach 659 cases (95% confidence interval = 579-749); and the male to female ratios ranged from 1.8 to 2.8. CONCLUSION The MPM epidemic in Taiwan will likely peak in 2012-2020 as a result of local asbestos consumption. Approximately 659 new MPM cases in the next 30 years warrant an urgent need to implement a total asbestos ban and put more resources on a comprehensive surveillance, diagnosis, and follow-up health care system for ARDs.
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Affiliation(s)
- Ro-Ting Lin
- Department of Occupational Safety and Health, College of Public Health, China Medical University, No. 91 Hsueh-Shih Road, Taichung, 40402, Taiwan; National Institute of Environmental Health Sciences, National Health Research Institutes, 35 Keyan Road, Zhunan, Miaoli County, 35053, Taiwan; Asbestos Diseases Research Institute, Concord Clinical School, University of Sydney, Gate 3 Hospital Road, Concord, NSW, 2139, Australia
| | - Yu-Yin Chang
- National Institute of Environmental Health Sciences, National Health Research Institutes, 35 Keyan Road, Zhunan, Miaoli County, 35053, Taiwan
| | - Jung-Der Wang
- Department of Public Health College of Medicine, National Cheng Kung University, No. 1, University Road, Tainan, 70101, Taiwan; Departments of Internal Medicine and Occupational and Environmental Medicine, National Cheng Kung University Hospital, No. 1, University Road, Tainan, 70101, Taiwan
| | - Lukas Jyuhn-Hsiarn Lee
- National Institute of Environmental Health Sciences, National Health Research Institutes, 35 Keyan Road, Zhunan, Miaoli County, 35053, Taiwan; Institute of Occupational Medicine and Industrial Hygiene, College of Public Health, National Taiwan University, No. 17, Xu-Zhou Road, Taipei, 100, Taiwan; Environmental and Occupational Medicine, Kaohsiung Medical University, 100, Shih-Chuan 1st Rd., Kaohsiung City, 807, Taiwan.
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