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Current Evidences and New Therapeutic Frontiers in Malignant Pleural Mesothelioma
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Current Evidences and New Therapeutic Frontiers in Malignant Pleural Mesothelioma

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Oncology".

Deadline for manuscript submissions: closed (30 November 2023) | Viewed by 17540

Special Issue Editors

Prof. Dr. Filippo Lococo

E-Mail Website
Guest Editor
1. Department of Thoracic Surgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
2. Università Cattolica del Sacro Cuore, Rome, Italy
Interests: pulmonary metastasectomy; malignant pleural mesothelioma; pulmonary laser resection; thymic and pleural tumors; hyperthermic intrathoracic chemotherapy (HITHOC)
Special Issues, Collections and Topics in MDPI journals
Dr. Luca Luzzi

E-Mail Website
Guest Editor
Department of Medicine, Surgery and Neurosciences, Siena University Hospital, 53100 Siena, Italy
Interests: esophageal cancer; lung transplantation; robotic surgery; video-assisted thoracic surgery; thymoma; mediastinal neoplasms

Special Issue Information

Dear Colleagues,

As you know, malignant pleural mesothelioma (MPM) is a very rare aggressive cancer affecting an increasing number of people worldwide.

In the last decade, the investigation of its biomolecular mechanisms have led to the definition of different types of mesothelioma on the basis of gene expression, but molecularly defined groups based on prognosis are still far from being defined.

At the same time, regardless of the treatment, long-term survival is extremely poor in MPM patients because no valid therapeutic strategies have been validated.

In particular, surgical resection for MPM is a controversial topic with no universally accepted guidelines. Similarly, the frontiers of oncology are still unexplored, with immunotherapeutic approach showing controversial results in these patients.

This Special Issue the following goals:

(1) To offer to the Readers an overview on the current therapeutic options in MPM;

(2) To analyze the pathological features, genetic profile and biomolecular mechanism of MPM;

(3) To report the new frontiers in the surgical and oncological treatment of MPM.

In this sense, all submissions addressing all of the above highlighted aspects on MPM are welcome to this Special Issue. Thus, original articles, comprehensive reviews, and expert opinions are of the utmost interest, given the expansive scope of this area.

Prof. Dr. Filippo Lococo
Dr. Luca Luzzi
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • malignant pleural mesothelioma
  • pleurectomy and decortication
  • immunotherapy
  • radiotherapy

Published Papers (6 papers)

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Editorial

Jump to: Research, Review

3 pages, 177 KiB  
Editorial
Malignant Pleural Mesothelioma: Time Is Running Out
by Filippo Lococo
J. Clin. Med. 2021, 10(4), 648; https://doi.org/10.3390/jcm10040648 - 08 Feb 2021
Cited by 4 | Viewed by 2399
Abstract
Malignant pleural mesothelioma (MPM) is a rare but highly malignant disease of the pleura usually related to asbestos exposure [...] Full article
(This article belongs to the Special Issue Current Evidences and New Therapeutic Frontiers in Malignant Pleural Mesothelioma)

Research

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13 pages, 1551 KiB  
Article
Relapse Patterns and Tailored Treatment Strategies for Malignant Pleural Mesothelioma Recurrence after Multimodality Therapy
by Alice Bellini, Andrea Dell’Amore, Stefano Terzi, Giovanni Zambello, Andrea Zuin, Giulia Pasello, Fiorella Calabrese, Marco Schiavon and Federico Rea
J. Clin. Med. 2021, 10(5), 1134; https://doi.org/10.3390/jcm10051134 - 08 Mar 2021
Cited by 9 | Viewed by 1796
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 [...] Read more.
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. Full article
(This article belongs to the Special Issue Current Evidences and New Therapeutic Frontiers in Malignant Pleural Mesothelioma)
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Review

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12 pages, 271 KiB  
Review
The Evolving Role of Immune-Checkpoint Inhibitors in Malignant Pleural Mesothelioma
by Maxime Borgeaud, Floryane Kim, Alex Friedlaender, Filippo Lococo, Alfredo Addeo and Fabrizio Minervini
J. Clin. Med. 2023, 12(5), 1757; https://doi.org/10.3390/jcm12051757 - 22 Feb 2023
Cited by 4 | Viewed by 1881
Abstract
Malignant pleural mesothelioma (MPM) is a rare cancer usually caused by asbestos exposure and associated with a very poor prognosis. After more than a decade without new therapeutic options, immune checkpoint inhibitors (ICIs) demonstrated superiority over standard chemotherapy, with improved overall survival in [...] Read more.
Malignant pleural mesothelioma (MPM) is a rare cancer usually caused by asbestos exposure and associated with a very poor prognosis. After more than a decade without new therapeutic options, immune checkpoint inhibitors (ICIs) demonstrated superiority over standard chemotherapy, with improved overall survival in the first and later-line settings. However, a significant proportion of patients still do not derive benefit from ICIs, highlighting the need for new treatment strategies and predictive biomarkers of response. Combinations with chemo-immunotherapy or ICIs and anti-VEGF are currently being evaluated in clinical trials and might change the standard of care in the near future. Alternatively, some non-ICI immunotherapeutic approaches, such as mesothelin targeted CAR-T cells or denditric-cells vaccines, have shown promising results in early phases of trials and are still in development. Finally, immunotherapy with ICIs is also being evaluated in the peri-operative setting, in the minority of patients presenting with resectable disease. The goal of this review is to discuss the current role of immunotherapy in the management of malignant pleural mesothelioma, as well as promising future therapeutic directions. Full article
(This article belongs to the Special Issue Current Evidences and New Therapeutic Frontiers in Malignant Pleural Mesothelioma)
9 pages, 456 KiB  
Review
Management of Pleural Effusion Secondary to Malignant Mesothelioma
by Valeria Musso, Cristina Diotti, Alessandro Palleschi, Davide Tosi, Alberto Aiolfi and Paolo Mendogni
J. Clin. Med. 2021, 10(18), 4247; https://doi.org/10.3390/jcm10184247 - 19 Sep 2021
Cited by 1 | Viewed by 4370
Abstract
Malignant pleural mesothelioma (MPM) is a highly aggressive pleural tumour which has been epidemiologically linked to occupational exposure to asbestos. MPM is often associated with pleural effusion, which is a common cause of morbidity and whose management remains a clinical challenge. In this [...] Read more.
Malignant pleural mesothelioma (MPM) is a highly aggressive pleural tumour which has been epidemiologically linked to occupational exposure to asbestos. MPM is often associated with pleural effusion, which is a common cause of morbidity and whose management remains a clinical challenge. In this review, we analysed the literature regarding the diagnosis and therapeutic options of pleural effusion secondary to mesothelioma. Our aim was to provide a comprehensive view on this subject, and a new algorithm was proposed as a practical aid to clinicians dealing with patients suffering from pleural effusion. Full article
(This article belongs to the Special Issue Current Evidences and New Therapeutic Frontiers in Malignant Pleural Mesothelioma)
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17 pages, 980 KiB  
Review
Molecular Fingerprints of Malignant Pleural Mesothelioma: Not Just a Matter of Genetic Alterations
by Eugenia Lorenzini, Alessia Ciarrocchi and Federica Torricelli
J. Clin. Med. 2021, 10(11), 2470; https://doi.org/10.3390/jcm10112470 - 02 Jun 2021
Cited by 8 | Viewed by 2767
Abstract
Malignant pleural mesothelioma (MPM) is a clinical emergency of our time. Being strongly associated with asbestos exposure, incidence of this cancer is ramping up these days in many industrialized countries and it will soon start to increase in many developing areas where the [...] Read more.
Malignant pleural mesothelioma (MPM) is a clinical emergency of our time. Being strongly associated with asbestos exposure, incidence of this cancer is ramping up these days in many industrialized countries and it will soon start to increase in many developing areas where the use of this silicate derivate is still largely in use. Deficiency of reliable markers for the early identification of these tumors and the limited efficacy of the currently available therapeutic options are the basis of the impressive mortality rate of MPM. These shortcomings reflect the very poor information available about the molecular basis of this disease. Results of the recently released deep profiling studies point to the epigenome as a central element in MPM development and progression. First, MPM is characterized by a low mutational burden and a highly peculiar set of mutations that hits almost exclusively epigenetic keepers or proteins controlling chromatin organization and function. Furthermore, asbestos does not seem to be associated with a distinctive mutational signature, while the precise mapping of epigenetic changes caused by this carcinogen has been defined, suggesting that alterations in epigenetic features are the driving force in the development of this disease. Last but not least, consistent evidence also indicates that, in the setting of MPM, chromatin rewiring and epigenetic alterations of cancer cells heavily condition the microenvironment, including the immune response. In this review we aim to point to the relevance of the epigenome in MPM and to highlight the dependency of this tumor on chromatin organization and function. We also intend to discuss the opportunity of targeting these mechanisms as potential therapeutic options for MPM. Full article
(This article belongs to the Special Issue Current Evidences and New Therapeutic Frontiers in Malignant Pleural Mesothelioma)
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10 pages, 2744 KiB  
Review
Surgical Management and Reconstruction of Diaphragm, Pericardium and Chest Wall in Mesothelioma Surgery: A Review
by Pietro Bertoglio, Elena Garelli, Jury Brandolini, Kenji Kawamukai, Filippo Antonacci, Sara Ricciardi, Alessandro Cipolli, Barbara Bonfanti, Sergio Nicola Forti Parri, Niccolò Daddi, Giampiero Dolci and Piergiorgio Solli
J. Clin. Med. 2021, 10(11), 2330; https://doi.org/10.3390/jcm10112330 - 26 May 2021
Cited by 6 | Viewed by 2501
Abstract
Mesothelioma is an aggressive disease arising from parietal pleura. Surgery is a valuable option in the frame of a multimodality treatment. Several surgical approaches have been standardized with the aim of a macroscopic complete resection; these often require homolateral diaphragm and pericardial resection [...] Read more.
Mesothelioma is an aggressive disease arising from parietal pleura. Surgery is a valuable option in the frame of a multimodality treatment. Several surgical approaches have been standardized with the aim of a macroscopic complete resection; these often require homolateral diaphragm and pericardial resection and reconstruction. Extrapleural pneumonectomy (EPP) and extended pleurectomy decortication (EPD) have been recognized as radical surgical procedures. Nevertheless, both operations are technically challenging and associated with a significant rate of peri-operative morbidity and non-negligible mortality. The diaphragmatic and pericardial reconstruction technique is mandatory to avoid respiratory impairment and to reduce post-operative complications like gastric and cardiac herniation. Moreover, in the case of localized chest wall recurrence, surgery might be considered a valuable therapeutical option for highly selected and fit patients. All the technical aspects of the resection and reconstruction of the diaphragm, pericardium, and chest wall are described as well as the possible use of new minimally invasive techniques. In addition, the choice of different prosthetic materials, considering the most recent innovations in the field, are discussed. Full article
(This article belongs to the Special Issue Current Evidences and New Therapeutic Frontiers in Malignant Pleural Mesothelioma)
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