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Nastase A, Mandal A, Lu SK, Anbunathan H, Morris-Rosendahl D, Zhang YZ, Sun XM, Gennatas S, Rintoul RC, Edwards M, Bowman A, Chernova T, Benepal T, Lim E, Taylor AN, Nicholson AG, Popat S, Willis AE, MacFarlane M, Lathrop M, Bowcock AM, Moffatt MF, Cookson WOCM. Integrated genomics point to immune vulnerabilities in pleural mesothelioma. Sci Rep 2021; 11:19138. [PMID: 34580349 PMCID: PMC8476593 DOI: 10.1038/s41598-021-98414-w] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 09/02/2021] [Indexed: 12/21/2022] Open
Abstract
Pleural mesothelioma is an aggressive malignancy with limited effective therapies. In order to identify therapeutic targets, we integrated SNP genotyping, sequencing and transcriptomics from tumours and low-passage patient-derived cells. Previously unrecognised deletions of SUFU locus (10q24.32), observed in 21% of 118 tumours, resulted in disordered expression of transcripts from Hedgehog pathways and the T-cell synapse including VISTA. Co-deletion of Interferon Type I genes and CDKN2A was present in half of tumours and was a predictor of poor survival. We also found previously unrecognised deletions in RB1 in 26% of cases and show sub-micromolar responses to downstream PLK1, CHEK1 and Aurora Kinase inhibitors in primary mesothelioma cells. Defects in Hippo pathways that included RASSF7 amplification and NF2 or LATS1/2 mutations were present in 50% of tumours and were accompanied by micromolar responses to the YAP1 inhibitor Verteporfin. Our results suggest new therapeutic avenues in mesothelioma and indicate targets and biomarkers for immunotherapy.
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Affiliation(s)
- Anca Nastase
- National Heart and Lung Institute, Imperial College London, Dovehouse Street, London, SW36LY, UK
| | - Amit Mandal
- National Heart and Lung Institute, Imperial College London, Dovehouse Street, London, SW36LY, UK
| | - Shir Kiong Lu
- National Heart and Lung Institute, Imperial College London, Dovehouse Street, London, SW36LY, UK
| | - Hima Anbunathan
- National Heart and Lung Institute, Imperial College London, Dovehouse Street, London, SW36LY, UK
| | - Deborah Morris-Rosendahl
- National Heart and Lung Institute, Imperial College London, Dovehouse Street, London, SW36LY, UK
- Clinical Genetics and Genomics, Royal Brompton and Harefield NHS Foundation Trust, London, UK
| | - Yu Zhi Zhang
- National Heart and Lung Institute, Imperial College London, Dovehouse Street, London, SW36LY, UK
- Department of Histopathology, Royal Brompton and Harefield NHS Foundation Trust, London, UK
| | - Xiao-Ming Sun
- Medical Research Council Toxicology Unit, University of Cambridge, Cambridge, UK
| | - Spyridon Gennatas
- National Heart and Lung Institute, Imperial College London, Dovehouse Street, London, SW36LY, UK
| | - Robert C Rintoul
- Department of Thoracic Oncology, Papworth Hospital, Cambridge, UK
- Department of Oncology, University of Cambridge, Cambridge, UK
| | - Matthew Edwards
- Clinical Genetics and Genomics, Royal Brompton and Harefield NHS Foundation Trust, London, UK
| | - Alex Bowman
- Department of Histopathology, Royal Brompton and Harefield NHS Foundation Trust, London, UK
| | - Tatyana Chernova
- Medical Research Council Toxicology Unit, University of Cambridge, Cambridge, UK
| | - Tim Benepal
- Department of Oncology, St George's Healthcare NHS Foundation Trust, London, UK
| | - Eric Lim
- Department of Thoracic Surgery, Royal Brompton and Harefield NHS Foundation Trust, London, UK
| | - Anthony Newman Taylor
- National Heart and Lung Institute, Imperial College London, Dovehouse Street, London, SW36LY, UK
| | - Andrew G Nicholson
- National Heart and Lung Institute, Imperial College London, Dovehouse Street, London, SW36LY, UK
- Department of Histopathology, Royal Brompton and Harefield NHS Foundation Trust, London, UK
| | - Sanjay Popat
- Department of Medicine, Royal Marsden Hospital, London, UK
- The Institute of Cancer Research, London, UK
| | - Anne E Willis
- Medical Research Council Toxicology Unit, University of Cambridge, Cambridge, UK
| | - Marion MacFarlane
- Medical Research Council Toxicology Unit, University of Cambridge, Cambridge, UK
| | - Mark Lathrop
- Department of Human Genetics, McGill Genome Centre, Montreal, QC, Canada
| | - Anne M Bowcock
- National Heart and Lung Institute, Imperial College London, Dovehouse Street, London, SW36LY, UK
| | - Miriam F Moffatt
- National Heart and Lung Institute, Imperial College London, Dovehouse Street, London, SW36LY, UK.
| | - William O C M Cookson
- National Heart and Lung Institute, Imperial College London, Dovehouse Street, London, SW36LY, UK.
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Alkhuja S, Miller A, Mastellone AJ, Markowitz S. Malignant pleural mesothelioma presenting as spontaneous pneumothorax: a case series and review. Am J Ind Med 2000; 38:219-23. [PMID: 10893511 DOI: 10.1002/1097-0274(200008)38:2<219::aid-ajim8>3.0.co;2-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Malignant pleural mesothelioma (MPM) is thought to arise from the mesothelial cells that line the pleural cavities. Most patients initially experience the insidious onset of chest pain or shortness of breath, and it rarely presents as spontaneous pneumothorax. CASE REPORTS We report four patients who presented in this manner. Three of the patients were exposed to asbestos directly or indirectly at shipyards during World War II; the fourth was exposed as an insulator's wife. Two of our cases were not recognized to have MPM on histologic examination at first thoracotomy and remained asymptomatic for 12 and 22 months, respectively. In none of the patients described herein, was spontaneous pneumothorax the cause of death. CONCLUSIONS Since many people were exposed to asbestos during and after World War II, spontaneous pneumothorax in a patient with the possibility of such exposure should raise the suspicion of malignant pleural mesothelioma.
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Affiliation(s)
- S Alkhuja
- Division of Pulmonary Medicine, Department of Medicine, Catholic Medical Center of Brooklyn and Queens, Jamaica, NY, USA.
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Purohit A, Moreau L, Dietemann A, Seibert R, Pauli G, Wihlm JM, Quoix E. Weekly systemic combination of cisplatin and interferon alpha 2a in diffuse malignant pleural mesothelioma. Lung Cancer 1998; 22:119-25. [PMID: 10022219 DOI: 10.1016/s0169-5002(98)00072-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The treatment of diffuse malignant pleural mesothelioma (DMPM) remains grim. Neither surgery, radiotherapy nor chemotherapy can be considered as a standard therapy. Immunotherapy with interferon (IFN) in combination with chemotherapy may be an interesting new approach. In 13 consecutive patients with DMPM, we used a weekly combination of cisplatin (CDDP) (60 mg/m2; day 2) and IFN alpha 2a (6 MU/day; days 1-4) in a protocol of two cycles of 4 weeks on/4 weeks off followed by 3 weeks on/3 weeks off. Total treatment duration was thus 25 weeks. In responders, IFN as maintenance monotherapy was continued for a further 6 months. There were nine males and four females with an average age of 65.3 years (range 51-72 years). Eleven had epithelial, one had mixed and one had a sarcomatoid form of DMPM. Five patients were classified as stage II, six as stage III and two as stage IV, as per the International Mesothelioma Interest Group. Thirty-five cycles were administered with a median of three cycles/patient (range 0.75-4). The median total cumulative dose of CDDP was 596 mg/m2 (range 114-861) and that of IFN alpha 2a was 264 MU (range 72-336). Four patients received IFN maintenance therapy, one for 3 months and three for 6 months. One patient had a complete response, four had a partial response, six had a stable disease and the disease progressed in one. One patient was non evaluable for response. All patients were assessable for toxicity. Hematological toxicity was the most frequently observed but was manageable (grade 3 anemia in five patients, grade 3 thrombocytopenia in three patients, grade 3 neutropenia in five patients). Grade 1 renal toxicity was observed in six patients, grade 2-3 asthenia in six patients and an average 5-kg weight loss was noted in nine patients. In conclusion, systemic combination of CDDP and IFN alpha 2a in large doses is effective at the expense of non-negligible toxicity.
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Affiliation(s)
- A Purohit
- Department of Respiratory Diseases, Hôpitaux Universitaires de Strasbourg, France
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