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Crovella S, Revelant A, Muraro E, Moura RR, Brandão L, Trovò M, Steffan A, Zacchi P, Zabucchi G, Minatel E, Borelli V. Biological Pathways Associated With the Development of Pulmonary Toxicities in Mesothelioma Patients Treated With Radical Hemithoracic Radiation Therapy: A Preliminary Study. Front Oncol 2021; 11:784081. [PMID: 35004305 PMCID: PMC8728021 DOI: 10.3389/fonc.2021.784081] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 11/29/2021] [Indexed: 01/05/2023] Open
Abstract
Radical hemithoracic radiotherapy (RHR), after lung-sparing surgery, has recently become a concrete therapeutic option for malignant pleural mesothelioma (MPM), an asbestos-related, highly aggressive tumor with increasing incidence and poor prognosis. Although the toxicity associated to this treatment has been reduced, it is still not negligible and must be considered when treating patients. Genetic factors appear to play a role determining radiotherapy toxicity. The aim of this study is the identification of biological pathways, retrieved through whole exome sequencing (WES), possibly associated to the development of lung adverse effects in MPM patients treated with RHR. The study included individuals with MPM, treated with lung-sparing surgery and chemotherapy, followed by RHR with curative intent, and followed up prospectively for development of pulmonary toxicity. Due to the strong impact of grade 3 pulmonary toxicities on the quality of life, compared with less serious adverse events, for genetic analyses, patients were divided into a none or tolerable pulmonary toxicity (NoSTox) group (grade ≤2) and a severe pulmonary toxicity (STox) group (grade = 3). Variant enrichment analysis allowed us to identify different pathway signatures characterizing NoSTox and Stox patients, allowing to formulate hypotheses on the protection from side effects derived from radiotherapy as well as factors predisposing to a worst response to the treatment. Our findings, being aware of the small number of patients analyzed, could be considered a starting point for the definition of a panel of pathways, possibly helpful in the management of MPM patients.
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Affiliation(s)
- Sergio Crovella
- Department of Biological and Environmental Sciences, College of Arts and Sciences, University of Qatar, Doha, Qatar
| | - Alberto Revelant
- Department of Radiation Oncology, Centro di Riferimento Oncologico di Aviano (CRO) Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS), Aviano, Italy
| | - Elena Muraro
- Immunopathology and Biomarker Unit, Department of Translational Research, Centro di Riferimento Oncologico di Aviano (CRO) Istituti di Ricovero e Cura a Carattere Scientifico, Aviano, Italy
| | - Ronald Rodrigues Moura
- Department of Advanced Diagnostics, Institute for Maternal and Child Health – Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS) “Burlo Garofolo”, Trieste, Italy
| | - Lucas Brandão
- Department of Advanced Diagnostics, Institute for Maternal and Child Health – Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS) “Burlo Garofolo”, Trieste, Italy
| | - Marco Trovò
- Radiation Oncology Department, Udine Academic Hospital, Udine, Italy
| | - Agostino Steffan
- Immunopathology and Biomarker Unit, Department of Translational Research, Centro di Riferimento Oncologico di Aviano (CRO) Istituti di Ricovero e Cura a Carattere Scientifico, Aviano, Italy
| | - Paola Zacchi
- Department of Life Sciences, University of Trieste, Trieste, Italy
| | | | - Emilio Minatel
- Department of Radiation Oncology, Centro di Riferimento Oncologico di Aviano (CRO) Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS), Aviano, Italy
| | - Violetta Borelli
- Department of Life Sciences, University of Trieste, Trieste, Italy
- *Correspondence: Violetta Borelli ,
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