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Branch K, Adusumilli PS, Zauderer MG. Some like it hot: the potential role of hyperthermic intrathoracic chemotherapy in the multimodality treatment of pleural mesothelioma. Transl Lung Cancer Res 2023; 12:187-189. [PMID: 36895927 PMCID: PMC9989819 DOI: 10.21037/tlcr-23-46] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 02/01/2023] [Indexed: 02/12/2023]
Affiliation(s)
- Kevin Branch
- Department of Surgery, Thoracic Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA.,Department of Surgery, State University of New York, Downstate Health Sciences University, Brooklyn, NY, USA
| | - Prasad S Adusumilli
- Department of Surgery, Thoracic Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Marjorie G Zauderer
- Department of Medicine, Thoracic Oncology Service, Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York, NY, USA
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Study on the Predictive Value of P53 Protein Expression in Brain Metastasis in NSCLC and the Mechanism of miR-424 Reversing Platinum Resistance in NSCLC. CONTRAST MEDIA & MOLECULAR IMAGING 2022; 2022:5273772. [PMID: 36043143 PMCID: PMC9377954 DOI: 10.1155/2022/5273772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 06/14/2022] [Accepted: 06/24/2022] [Indexed: 11/17/2022]
Abstract
In order to analyze the predictive value of P53 protein expression in brain metastases in NSCLC and the mechanism of miR-424 reversing platinum resistance in NSCLC, a retrospective analysis is conducted in this study. Eighty-two NSCLC patients who received relevant diagnosis and treatment in our hospital from September 2020 to September 2021 are chosen. The prognosis of the patients is observed, and the patients were divided into two groups according to the occurrence of BMS. The comparison of clinical baseline data and the expression of P53 protein and miR-424 after surgery are performed. Furthermore, the predictive value of the P53 protein gene on the occurrence of BMS in NSCLC is analyzed by the ROC curve, and the expression of miR-424 in serum of the patients before and after drug resistance is compared. The results demonstrate that the expression of P53 protein has a high predictive value for predicting the occurrence of BRAIN metastases in NSCLC patients. Also, the high expression of miR-424 suggests that it is closely related to the occurrence of platinum resistance in NSCLC patients.
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Bellini A, Mazzarra S, Sterrantino S, Argnani D, Stella F. Second Surgery for Recurrent Malignant Pleural Mesothelioma after Multimodality Treatment: A Systematic Review. J Clin Med 2022; 11:jcm11123340. [PMID: 35743417 PMCID: PMC9225173 DOI: 10.3390/jcm11123340] [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: 05/19/2022] [Revised: 06/06/2022] [Accepted: 06/08/2022] [Indexed: 02/01/2023] Open
Abstract
Malignant pleural mesothelioma (MPM) is an aggressive asbestos-related tumour with poor prognosis. To date, a multimodality treatment, including chemotherapy and surgery, with or without radiotherapy, is the gold standard therapy for selected patients with epithelioid and early-stage MPM. In this setting, the goal of surgery is to achieve the macroscopic complete resection, obtained by either extrapleural pneumonectomy or pleurectomy/decortication. Failure, in local and/or distant sites, is one of the major concerns; in fact, there has been no established treatment for the recurrence of MPM after the multimodal approach, and the role of surgery in this context is still controversial. By using electronic databases, studies that included recurrent MPM patients who underwent a second surgery were identified. The endpoints included were: a pattern of recurrence, post-recurrence survival (PRS), and the type of second surgery. When available, factors predicting better PRS and perioperative mortality and morbidity were collected. This systematic review offers an overview of the results that are currently obtained in patients undergoing a second surgery for relapsed MPM, with the aim to provide a comprehensive view on this subject that explores if a second surgery leads to an improvement in survival.
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Affiliation(s)
- Alice Bellini
- Department of Surgery, Division of Thoracic Surgery, G.B. Morgagni—L. Pierantoni Hospital, Via Carlo Forlanini n.34, 47121 Forlì, Italy; (S.M.); (S.S.); (D.A.); (F.S.)
- Correspondence: ; Tel.: +39-0543-735650
| | - Sara Mazzarra
- Department of Surgery, Division of Thoracic Surgery, G.B. Morgagni—L. Pierantoni Hospital, Via Carlo Forlanini n.34, 47121 Forlì, Italy; (S.M.); (S.S.); (D.A.); (F.S.)
| | - Sara Sterrantino
- Department of Surgery, Division of Thoracic Surgery, G.B. Morgagni—L. Pierantoni Hospital, Via Carlo Forlanini n.34, 47121 Forlì, Italy; (S.M.); (S.S.); (D.A.); (F.S.)
| | - Desideria Argnani
- Department of Surgery, Division of Thoracic Surgery, G.B. Morgagni—L. Pierantoni Hospital, Via Carlo Forlanini n.34, 47121 Forlì, Italy; (S.M.); (S.S.); (D.A.); (F.S.)
| | - Franco Stella
- Department of Surgery, Division of Thoracic Surgery, G.B. Morgagni—L. Pierantoni Hospital, Via Carlo Forlanini n.34, 47121 Forlì, Italy; (S.M.); (S.S.); (D.A.); (F.S.)
- Department of Diagnostic and Specialty Medicine—DIMES of the Alma Mater Studiorum, Division of Thoracic Surgery, University of Bologna, G.B. Morgagni—L. Pierantoni Hospital, via Carlo Forlanini n. 34, 47121 Forlì, Italy
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Bellini A, Dell’Amore A, Terzi S, Zambello G, Zuin A, Pasello G, Calabrese F, Schiavon M, Rea F. Relapse Patterns and Tailored Treatment Strategies for Malignant Pleural Mesothelioma Recurrence after Multimodality Therapy. J Clin Med 2021; 10:jcm10051134. [PMID: 33800433 PMCID: PMC7962831 DOI: 10.3390/jcm10051134] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 03/01/2021] [Accepted: 03/01/2021] [Indexed: 12/31/2022] Open
Abstract
To date, there have been no established therapies for recurrent malignant pleural mesothelioma (MPM) after multimodality treatment. Aims of this retrospective study are to analyze the recurrence pattern, its treatment and to identify the predictors of best oncological outcomes for relapsed MPM, comparing extrapleural pneumonectomy (EPP) vs. pleurectomy/decortication (PD). Study population: 94 patients with recurrence of MPM after multimodality treatment underwent macroscopic complete resection (52.1% with EPP and 47.9% with PD) between July 1994 and February 2020. Distant spread was the most frequent pattern of recurrence (71.3%), mostly in the EPP group, while the PD group showed a higher local-only failure rate. Post-recurrence treatment was administered in 86.2%, whereas best supportive care was administered in 13.8%. Median post-recurrence survival (PRS) was 12 months (EPP 14 vs. PD 8 months, p = 0.4338). At multivariate analysis, predictors of best PRS were epithelial histology (p = 0.026, HR 0.491, IC95% 0.263–0.916), local failure (p = 0.027, HR 0.707, IC95% 0.521–0.961), DFS ≥ 12 months (p = 0.006, HR 0.298, IC95% 0.137–0.812) and post-recurrence medical treatment (p = 0.046, HR 0.101, IC95% 0.897–0.936). The type of surgical intervention seems not to influence the PRS if patients are fit enough to face post-recurrence treatments. In patients with a prolonged disease-free interval, in the case of recurrence the most appropriate treatment seems to be the systemic medical therapy, even in the case of local-only relapse.
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Affiliation(s)
- Alice Bellini
- Thoracic Surgery Division, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, 35128 Padova, Italy; (A.B.); (S.T.); (G.Z.); (A.Z.); (M.S.); (F.R.)
| | - Andrea Dell’Amore
- Thoracic Surgery Division, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, 35128 Padova, Italy; (A.B.); (S.T.); (G.Z.); (A.Z.); (M.S.); (F.R.)
- Correspondence: ; Tel.: +49-821-22-42; Fax: +49-821-22-20
| | - Stefano Terzi
- Thoracic Surgery Division, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, 35128 Padova, Italy; (A.B.); (S.T.); (G.Z.); (A.Z.); (M.S.); (F.R.)
| | - Giovanni Zambello
- Thoracic Surgery Division, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, 35128 Padova, Italy; (A.B.); (S.T.); (G.Z.); (A.Z.); (M.S.); (F.R.)
| | - Andrea Zuin
- Thoracic Surgery Division, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, 35128 Padova, Italy; (A.B.); (S.T.); (G.Z.); (A.Z.); (M.S.); (F.R.)
| | - Giulia Pasello
- Medical Oncology, Veneto Institute of Oncology IOV IRCCS, 35128 Padova, Italy;
| | - Fiorella Calabrese
- Pathology Division, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, 35128 Padova, Italy;
| | - Marco Schiavon
- Thoracic Surgery Division, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, 35128 Padova, Italy; (A.B.); (S.T.); (G.Z.); (A.Z.); (M.S.); (F.R.)
| | - Federico Rea
- Thoracic Surgery Division, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, 35128 Padova, Italy; (A.B.); (S.T.); (G.Z.); (A.Z.); (M.S.); (F.R.)
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Biomarkers for Malignant Pleural Mesothelioma-A Novel View on Inflammation. Cancers (Basel) 2021; 13:cancers13040658. [PMID: 33562138 PMCID: PMC7916017 DOI: 10.3390/cancers13040658] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 01/25/2021] [Accepted: 02/02/2021] [Indexed: 12/14/2022] Open
Abstract
Malignant pleural mesothelioma (MPM) is an aggressive disease with limited treatment response and devastating prognosis. Exposure to asbestos and chronic inflammation are acknowledged as main risk factors. Since immune therapy evolved as a promising novel treatment modality, we want to reevaluate and summarize the role of the inflammatory system in MPM. This review focuses on local tumor associated inflammation on the one hand and systemic inflammatory markers, and their impact on MPM outcome, on the other hand. Identification of new biomarkers helps to select optimal patient tailored therapy, avoid ineffective treatment with its related side effects and consequently improves patient's outcome in this rare disease. Additionally, a better understanding of the tumor promoting and tumor suppressing inflammatory processes, influencing MPM pathogenesis and progression, might also reveal possible new targets for MPM treatment. After reviewing the currently available literature and according to our own research, it is concluded that the suppression of the specific immune system and the activation of its innate counterpart are crucial drivers of MPM aggressiveness translating to poor patient outcome.
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