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Krishnamurthy K, Oh KS, Alghamdi S, Sriganeshan V, Poppiti R. A study of somatic BRCA variants and their putative effect on protein properties in malignant mesothelioma. Pleura Peritoneum 2023; 8:19-25. [PMID: 37020472 PMCID: PMC10067552 DOI: 10.1515/pp-2023-0003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Accepted: 02/23/2023] [Indexed: 04/04/2023] Open
Abstract
Abstract
Objectives
The aim of this study is to analyze the prevalence of somatic mutations in BRCA1 and BRCA2 in malignant mesothelioma and their putative impact on protein properties.
Methods
Eighteen cases of malignant mesothelioma were retrieved from the archives and for next generation sequencing analysis of BRCA1 and BRCA2 genes. Variants were analyzed using Ensembl VEP17, Polyphen 2.0 software, SIFT software, MutpredV2, and SWISS-MODEL homology-modeling pipeline server.
Results
BRCA2 variants were found in significantly higher percentage (22%) of cases (p=0.02). Five missense variants were identified. These were p.A2351P, p.T2250A, p.A895V, pG1771D, and p.R2034C. The SIFT scores of all except one were ≥ 0.03. The Polyphen scores of these four alterations were ≤0.899. In case of p.A2315, the SIFT score was 0.01, while the Polyphen 2 score was 0.921. MutPred2 scores were ≤0.180 for all. Loss of intrinsic disorder was predicted (Pr=0.32, p=0.07) for p.R2034C, while gain of intrinsic disorder was predicted for p.A2351P (Pr=0.36, p=0.01) and p.G1771D (Pr=0.34, p=0.02).
Conclusions
BRCA2 somatic variants were identified in 22% cases of malignant mesotheliomas in this study. The variants localize more frequently to the disordered regions of the protein and are predicted to affect the level of disorder.
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Affiliation(s)
- Kritika Krishnamurthy
- Department of Pathology , Montefiore Medical Center, Albert Einstein College of Medicine , Bronx , NY , USA
| | - Kei Shing Oh
- AM Rywlin Department of Pathology , Mount Sinai Medical Center , Miami Beach , FL , USA
| | - Sarah Alghamdi
- AM Rywlin Department of Pathology , Mount Sinai Medical Center , Miami Beach , FL , USA
- Pathology , FIU/Herbert Werthein College of Medicine , Miami , FL , USA
| | - Vathany Sriganeshan
- AM Rywlin Department of Pathology , Mount Sinai Medical Center , Miami Beach , FL , USA
- Pathology , FIU/Herbert Werthein College of Medicine , Miami , FL , USA
| | - Robert Poppiti
- AM Rywlin Department of Pathology , Mount Sinai Medical Center , Miami Beach , FL , USA
- Pathology , FIU/Herbert Werthein College of Medicine , Miami , FL , USA
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Karnan S, Ota A, Murakami H, Rahman ML, Hasan MN, Wahiduzzaman M, Hanamura I, Quang Vu L, Inoko A, Hyodo T, Konishi H, Tsuzuki S, Hosokawa Y. Identification of CD24 as a potential diagnostic and therapeutic target for malignant pleural mesothelioma. Cell Death Discov 2020; 6:127. [PMID: 33298865 DOI: 10.1038/s41420-020-00364-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 09/28/2020] [Accepted: 10/30/2020] [Indexed: 12/13/2022] Open
Abstract
Malignant pleural mesothelioma (MPM) is an aggressive malignancy of the pleura that is currently incurable due to the lack of an effective early diagnostic method and specific medication. The CDKN2A (p16) and NF2 genes are both frequently mutated in MPM. To understand how these mutations contribute to MPM tumor growth, we generated NF2/p16 double-knockout (DKO) cell clones using human MeT-5A and HOMC-B1 mesothelial cell lines. Cell growth and migration activities were significantly increased in DKO compared with parental cells. cDNA microarray analysis revealed differences in global gene expression profiles between DKO and parental cells. Quantitative PCR and western blot analyses showed upregulation of CD24 concomitant with increased phosphorylation of AKT, p70S6K, and c-Jun in DKO clones. This upregulation was abrogated by exogenous expression of NF2 and p16. CD24 knockdown in DKO cells significantly decreased TGF-β1 expression and increased expression of E-cadherin, an epithelial-mesenchymal transition marker. CD24 was highly expressed in human mesothelioma tissues (28/45 cases, 62%) and associated with the loss of NF2 and p16. Public data analysis revealed a significantly shorter survival time in MPM patients with high CD24 gene expression levels. These results strongly indicate the potential use of CD24 as a prognostic marker as well as a novel diagnostic and therapeutic target for MPM.
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Mummudi N, Khan A, Tibdewal A, Kumar R, Jiwnani S, Karimundackal G, Pramesh C, Agarwal JP. Trimodality treatment in malignant pleural mesothelioma - Ordeal or real deal? Rep Pract Oncol Radiother 2020; 25:876-881. [PMID: 32982593 PMCID: PMC7498860 DOI: 10.1016/j.rpor.2020.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Revised: 06/29/2020] [Accepted: 08/11/2020] [Indexed: 10/23/2022] Open
Abstract
BACKGROUND Management of MPM is complex and controversial as there is a paucity of good quality evidence. We report the toxicity and outcomes in patients who received trimodality treatment for non-metastatic MPM at our institution. METHODS & MATERIALS We reviewed the electronic medical records of surgically managed MPM patients at our institution in the last decade. Dosimetric parameters of target volume and organs at risk were documented by the treatment planning workstation. SPSS was used for statistical analysis. RESULTS Between January 2008 and October 2018, 21 patients underwent surgery for MPM - all but 2 patients underwent extra-pleural pneumonectomy (EPP); epithelioid MPM was the most common histology. All patients, except 2, received neoadjuvant Pemetrexed/platinum doublet chemotherapy. Fourteen patients received adjuvant hemithoracic RT; ten patients were treated with a conformal technique at our institute and dosimetric data was available for analysis. Average time to start RT after surgery was 51 days (range 32-82 days). All patients were treated with a conformal technique using IMRT/VMAT to a dose of 45Gy in 25 fractions. Mean overall RT duration was 35 days (range 30-42 days). Grade I/II Pneumonitis was seen in 4 patients. One patient developed grade III acute lung toxicity unrelated to RT. At a median follow up of 25 months, 8 patients had died, of whom six died due to the disease and two died in the immediate post op period. Two-year DFS and OS were 58% and 73%, respectively. CONCLUSION In spite of the extensive surgery and complex hemithoracic RT, we demonstrated excellent dosimetry, toxicity profile and favorable outcomes in non-metastatic MPM.
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Affiliation(s)
- Naveen Mummudi
- Department of Radiation Oncology, Tata Memorial Centre, Homi Bhabha National Institute, India
| | - Asfiya Khan
- Department of Radiation Oncology, Tata Memorial Centre, Homi Bhabha National Institute, India
| | - Anil Tibdewal
- Department of Radiation Oncology, Tata Memorial Centre, Homi Bhabha National Institute, India
| | - Rajiv Kumar
- Department of Pathology, Tata Memorial Centre, Homi Bhabha National Institute, India
| | - Sabita Jiwnani
- Department of Thoracic Surgery, Tata Memorial Centre, Homi Bhabha National Institute, India
| | - George Karimundackal
- Department of Thoracic Surgery, Tata Memorial Centre, Homi Bhabha National Institute, India
| | - C.S. Pramesh
- Department of Thoracic Surgery, Tata Memorial Centre, Homi Bhabha National Institute, India
| | - Jai Prakash Agarwal
- Department of Radiation Oncology, Tata Memorial Centre, Homi Bhabha National Institute, India
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Bonelli M, Terenziani R, Zoppi S, Fumarola C, La Monica S, Cretella D, Alfieri R, Cavazzoni A, Digiacomo G, Galetti M, Petronini PG. Dual Inhibition of CDK4/6 and PI3K/AKT/mTOR Signaling Impairs Energy Metabolism in MPM Cancer Cells. Int J Mol Sci 2020; 21:ijms21145165. [PMID: 32708306 PMCID: PMC7403976 DOI: 10.3390/ijms21145165] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 07/18/2020] [Accepted: 07/20/2020] [Indexed: 12/12/2022] Open
Abstract
Background: Malignant pleural mesothelioma (MPM) is an aggressive malignancy associated to asbestos exposure. One of the most frequent genetic alteration in MPM patients is CDKN2A/ARF loss, leading to aberrant activation of the Rb pathway. In MPM cells, we previously demonstrated the therapeutic efficacy of targeting this signaling with the CDK4/6 inhibitor palbociclib in combination with PI3K/mTOR inhibitors. Here, we investigated whether such combination may have an impact on cell energy metabolism. Methods: The study was performed in MPM cells of different histotypes; metabolic analyses were conducted by measuring GLUT-1 expression and glucose uptake/consumption, and by SeaHorse technologies. Results: MPM cell models differed for their ability to adapt to metabolic stress conditions, such as glucose starvation and hypoxia. Independently of these differences, combined treatments with palbociclib and PI3K/mTOR inhibitors inhibited cell proliferation more efficaciously than single agents. The drugs alone reduced glucose uptake/consumption as well as glycolysis, and their combination further enhanced these effects under both normoxic and hypoxic conditions. Moreover, the drug combinations significantly impaired mitochondrial respiration as compared with individual treatments. These metabolic effects were mediated by the concomitant inhibition of Rb/E2F/c-myc and PI3K/AKT/mTOR signaling. Conclusions: Dual blockade of glycolysis and respiration contributes to the anti-tumor efficacy of palbociclib-PI3K/mTOR inhibitors combination.
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Affiliation(s)
- Mara Bonelli
- Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy; (M.B.); (R.T.); (S.Z.); (S.L.M.); (D.C.); (R.A.); (A.C.); (G.D.); (P.G.P.)
| | - Rita Terenziani
- Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy; (M.B.); (R.T.); (S.Z.); (S.L.M.); (D.C.); (R.A.); (A.C.); (G.D.); (P.G.P.)
| | - Silvia Zoppi
- Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy; (M.B.); (R.T.); (S.Z.); (S.L.M.); (D.C.); (R.A.); (A.C.); (G.D.); (P.G.P.)
| | - Claudia Fumarola
- Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy; (M.B.); (R.T.); (S.Z.); (S.L.M.); (D.C.); (R.A.); (A.C.); (G.D.); (P.G.P.)
- Correspondence: ; Tel.: +39-0521-903762
| | - Silvia La Monica
- Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy; (M.B.); (R.T.); (S.Z.); (S.L.M.); (D.C.); (R.A.); (A.C.); (G.D.); (P.G.P.)
| | - Daniele Cretella
- Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy; (M.B.); (R.T.); (S.Z.); (S.L.M.); (D.C.); (R.A.); (A.C.); (G.D.); (P.G.P.)
| | - Roberta Alfieri
- Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy; (M.B.); (R.T.); (S.Z.); (S.L.M.); (D.C.); (R.A.); (A.C.); (G.D.); (P.G.P.)
| | - Andrea Cavazzoni
- Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy; (M.B.); (R.T.); (S.Z.); (S.L.M.); (D.C.); (R.A.); (A.C.); (G.D.); (P.G.P.)
| | - Graziana Digiacomo
- Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy; (M.B.); (R.T.); (S.Z.); (S.L.M.); (D.C.); (R.A.); (A.C.); (G.D.); (P.G.P.)
| | - Maricla Galetti
- INAIL Research, Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, 00078 Monte Porzio Catone (Rome), Italy;
| | - Pier Giorgio Petronini
- Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy; (M.B.); (R.T.); (S.Z.); (S.L.M.); (D.C.); (R.A.); (A.C.); (G.D.); (P.G.P.)
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5
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Panou V, Røe OD. Inherited Genetic Mutations and Polymorphisms in Malignant Mesothelioma: A Comprehensive Review. Int J Mol Sci 2020; 21:ijms21124327. [PMID: 32560575 PMCID: PMC7352726 DOI: 10.3390/ijms21124327] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 06/09/2020] [Accepted: 06/11/2020] [Indexed: 12/12/2022] Open
Abstract
Malignant mesothelioma (MM) is mainly caused by air-born asbestos but genetic susceptibility is also suspected to be a risk factor. Recent studies suggest an increasing number of candidate genes that may predispose to MM besides the well-characterized BRCA1-associated protein-1 gene. The aim of this review is to summarize the most important studies on germline mutations for MM. A total of 860 publications were retrieved from Scopus, PubMed and Web of Science, of which 81 met the inclusion criteria and were consider for this review. More than 50% of the genes that are reported to predispose to MM are involved in DNA repair mechanisms, and the majority of them have a role in the homologous recombination pathway. Genetic alterations in tumor suppressor genes involved in chromatin, transcription and hypoxia regulation have also been described. Furthermore, we identified several single nucleotide polymorphisms (SNPs) that may promote MM tumorigenesis as a result of an asbestos-gene interaction, including SNPs in DNA repair, carcinogen detoxification and other genes previously associated with other malignancies. The identification of inherited mutations for MM and an understanding of the underlying pathways may allow early detection and prevention of malignancies in high-risk individuals and pave the way for targeted therapies.
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Affiliation(s)
- Vasiliki Panou
- Department of Respiratory Medicine, Odense University Hospital, 5000 Odense, Denmark
- Department of Respiratory Medicine, Aalborg University Hospital, 9000 Aalborg, Denmark
- Clinical Institute, Aalborg University Hospital, 9000 Aalborg, Denmark;
- Correspondence:
| | - Oluf Dimitri Røe
- Clinical Institute, Aalborg University Hospital, 9000 Aalborg, Denmark;
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, 7491 Trondheim, Norway
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Wahiduzzaman M, Karnan S, Ota A, Hanamura I, Murakami H, Inoko A, Rahman ML, Hyodo T, Konishi H, Tsuzuki S, Hosokawa Y. Establishment and characterization of CRISPR/Cas9-mediated NF2 -/- human mesothelial cell line: Molecular insight into fibroblast growth factor receptor 2 in malignant pleural mesothelioma. Cancer Sci 2018; 110:180-193. [PMID: 30417500 PMCID: PMC6317947 DOI: 10.1111/cas.13871] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Revised: 11/06/2018] [Accepted: 11/06/2018] [Indexed: 12/12/2022] Open
Abstract
Malignant pleural mesothelioma (MPM), a highly refractory tumor, is currently incurable due to the lack of an early diagnosis method and medication, both of which are urgently needed to improve the survival and/or quality of life of patients. NF2 is a tumor suppressor gene and is frequently mutated in MPM. Using a CRISPR/Cas9 system, we generated an NF2‐knockout human mesothelial cell line, MeT‐5A (NF2‐KO). In NF2‐KO cell clones, cell growth, clonogenic activity, migration activity, and invasion activity significantly increased compared with those in NF2‐WT cell clones. Complementary DNA microarray analysis clearly revealed the differences in global gene expression profile between NF2‐WT and NF2‐KO cell clones. Quantitative PCR analysis and western blot analysis showed that the upregulation of fibroblast growth factor receptor 2 (FGFR2) was concomitant with the increases in phosphorylation levels of JNK, c‐Jun, and retinoblastoma (Rb) in NF2‐KO cell clones. These increases were all abrogated by the exogenous expression of NF2 in the NF2‐KO clone. In addition, the disruption of FGFR2 in the NF2‐KO cell clone suppressed cell proliferation as well as the phosphorylation levels of JNK, c‐Jun, and Rb. Notably, FGFR2 was found to be highly expressed in NF2‐negative human mesothelioma tissues (11/12 cases, 91.7%) but less expressed in NF2‐positive tissues. Collectively, these findings suggest that NF2 deficiency might play a role in the tumorigenesis of human mesothelium through mediating FGFR2 expression; FGFR2 would be a candidate molecule to develop therapeutic and diagnostic strategies for targeting MPM with NF2 loss.
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Affiliation(s)
- Md Wahiduzzaman
- Department of Biochemistry, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Sivasundaram Karnan
- Department of Biochemistry, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Akinobu Ota
- Department of Biochemistry, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Ichiro Hanamura
- Division of Hematology, Department of Internal Medicine, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Hideki Murakami
- Department of Pathology, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Akihito Inoko
- Division of Cancer Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya, Japan
| | - Md Lutfur Rahman
- Department of Biochemistry, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Toshinori Hyodo
- Department of Biochemistry, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Hiroyuki Konishi
- Department of Biochemistry, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Shinobu Tsuzuki
- Department of Biochemistry, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Yoshitaka Hosokawa
- Department of Biochemistry, Aichi Medical University School of Medicine, Nagakute, Japan
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7
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Cincinelli R, Musso L, Artali R, Guglielmi MB, La Porta I, Melito C, Colelli F, Cardile F, Signorino G, Fucci A, Frusciante M, Pisano C, Dallavalle S. Hybrid topoisomerase I and HDAC inhibitors as dual action anticancer agents. PLoS One 2018; 13:e0205018. [PMID: 30300374 PMCID: PMC6177136 DOI: 10.1371/journal.pone.0205018] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Accepted: 09/18/2018] [Indexed: 12/29/2022] Open
Abstract
Recent studies have shown that HDAC inhibitors act synergistically with camptothecin derivatives in combination therapies. To exploit this synergy, new hybrid molecules targeting simultaneously topoisomerase I and HDAC were designed. In particular, a selected multivalent agent containing a camptothecin and a SAHA-like template showed a broad spectrum of antiproliferative activity, with IC50 values in the nanomolar range. Preliminary in vivo results indicated a strong antitumor activity on human mesothelioma primary cell line MM473 orthotopically xenografted in CD-1 nude mice and very high tolerability.
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Affiliation(s)
- Raffaella Cincinelli
- Department of Food, Environmental and Nutritional Sciences, Università degli Studi di Milano, Milano, Italy
| | - Loana Musso
- Department of Food, Environmental and Nutritional Sciences, Università degli Studi di Milano, Milano, Italy
| | | | | | | | - Carmela Melito
- Biogem, Research Institute, Ariano Irpino, Avellino, Italy
| | | | | | | | | | | | - Claudio Pisano
- Biogem, Research Institute, Ariano Irpino, Avellino, Italy
- * E-mail: (SD); (CP)
| | - Sabrina Dallavalle
- Department of Food, Environmental and Nutritional Sciences, Università degli Studi di Milano, Milano, Italy
- * E-mail: (SD); (CP)
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8
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Grosso F, Roveta A, Gallizzi G, Belletti M. Management of recurrent pleural mesothelioma: Successful rechallenge with nintedanib in combination with chemotherapy. Clin Case Rep 2018; 6:2000-2004. [PMID: 30349716 PMCID: PMC6186873 DOI: 10.1002/ccr3.1775] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Accepted: 07/04/2018] [Indexed: 11/12/2022] Open
Abstract
Malignant pleural mesothelioma (MPM) is a rare neoplasm, generally caused by asbestos exposure. This case details how a patient treated with nintedanib during the LUME-Meso study was rechallenged with nintedanib. The findings highlight the benefit of nintedanib rechallenge and the potential use of continuous anti-angiogenic therapy in MPM treatment.
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Affiliation(s)
- Federica Grosso
- Mesothelioma UnitSS Antonio e Biagio General HospitalAlessandriaItaly
| | - Annalisa Roveta
- Clinical Trial CenterSS Antonio e Biagio General HospitalAlessandriaItaly
| | - Giulia Gallizzi
- Department of OncologySanto Spirito HospitalCasale MonferratoItaly
| | - Marco Belletti
- Department of RadiologySS Antonio e Biagio General HospitalAlessandriaItaly
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9
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Sattar N, Durrance R, Khan A, Patel N, Mora M, Shalonov A. Malignant mesothelioma presenting as recurrent hydro-pneumothorax: An atypical case presentation and literature review. Respir Med Case Rep 2018; 23:152-155. [PMID: 29719805 PMCID: PMC5925959 DOI: 10.1016/j.rmcr.2018.02.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Revised: 02/19/2018] [Accepted: 02/22/2018] [Indexed: 12/05/2022] Open
Abstract
Malignant Pleural Mesothelioma (MPM) is a rare pleural malignancy, with a vague presentation complicated by a decades-long latency period between environmental exposure and clinical manifestations. Spontaneous hydro-pneumothorax is a rare presentation of MPM, most often requiring invasive tissue biopsy to confirm the etiologic diagnosis. We present the case of 79-year-old male smoker with no documented history of asbestos exposure, who was found to have MPM after presenting with dyspnea and subsequently found to have recurrent hydro-pneumothorax. On Literature review of the limited documented cases of MPM with hydro-pneumothorax, we found an exclusively male population with a significant smoking history, a marked right sided pathology predominance, and a generally poor prognosis. While this corresponds with the examined case, and suggests that the presence of hydro-pneumothorax implies a high-grade tumor and significant tissue invasion, and therefore poor prognosis similar to that of stage 4 disease, it differs from more generalized case reviews of MPM, most importantly in their anatomical descriptions, prognostic indicators, and epidemiologic tendencies.
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Affiliation(s)
- Nadia Sattar
- Department of Internal Medicine, Jamaica Hospital Medical Center, 8900 Van Wyck Expressway, Jamaica NY 11420, United States
| | - Richard Durrance
- Department of Internal Medicine, Jamaica Hospital Medical Center, 8900 Van Wyck Expressway, Jamaica NY 11420, United States
| | - Ahmed Khan
- Department of Internal Medicine, Jamaica Hospital Medical Center, 8900 Van Wyck Expressway, Jamaica NY 11420, United States
| | - Nilesh Patel
- Department of Internal Medicine, Jamaica Hospital Medical Center, 8900 Van Wyck Expressway, Jamaica NY 11420, United States
| | - Maximo Mora
- Department of Pathology, Jamaica Hospital Medical Center, 8900 Van Wyck Expressway, Jamaica NY 11420, United States
| | - Artur Shalonov
- Department of Pulmonology, Jamaica Hospital Medical Center, 8900 Van Wyck Expressway, Jamaica NY 11420, United States
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10
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Shintani Y, Hasegawa S, Takuwa T, Aoe K, Kato K, Fujimoto N, Hida Y, Morise M, Moriya Y, Morohoshi T, Okumura M, Yoshino I. Prospective registry database of patients with malignant mesothelioma: directions for a future Japanese registry-based lung cancer study. J Thorac Dis 2018; 10:1968-1971. [PMID: 29707353 DOI: 10.21037/jtd.2018.03.53] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Background The International Association for the Study of Lung Cancer, in collaboration with members of the International Mesothelioma Interest Group (IMIG), developed a large international database and TNM-based system to study malignant pleural mesothelioma (MPM). However, this database has some limitations since it was a retrospective study and it was based predominantly on surgical cases. The Japanese Joint Committee of Lung Cancer Registry (JJCLCR) employs a project of prospective registry database of patients in Japan with MPM in order to clarify MPM's epidemiology, current management practices, and prognosis and also to investigate the potential capabilities to target the best patients for therapy. Methods Tumor stage is described using the 7th and 8th versions of IMIG staging system. This prospective cohort study has been conducted from April 1, 2017 to March 31, 2019. Discussion We will analyze the data in this registry to determine the most recent outcomes and trends related to MPM treatment in Japan. The present prospective study is expected to validate the 8th version of IMIG staging system, and to investigate whether tumor thickness is a reliable T-descriptor. Trial registration ClinicalTrials.gov Identifier: UMIN 000024664.
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Affiliation(s)
- Yasushi Shintani
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Seiki Hasegawa
- Department of Thoracic Surgery, Hyogo College of Medicine, Hyogo, Japan
| | - Teruhisa Takuwa
- Department of Thoracic Surgery, Hyogo College of Medicine, Hyogo, Japan
| | - Keisuke Aoe
- Department of Medical Oncology, National Hospital Organization Yamaguchi-Ube Medical Center, Yamaguchi, Japan
| | - Katsuya Kato
- Department of Diagnostic Radiology 2, Kawasaki Medical School, Okayama, Japan
| | - Nobukazu Fujimoto
- Department of Medical Oncology, Okayama Rosai Hospital, Okayama, Japan
| | - Yasuhiro Hida
- Department of Cardiovascular and Thoracic Surgery, Hokkaido University Graduate School of Medicine, Hokkaido, Japan
| | - Masahiro Morise
- Department of Respiratory Medicine, Nagoya University Graduate School of Medicine, Aichi, Japan
| | - Yasumitsu Moriya
- Division of General Thoracic Surgery, Chiba Rosai Hospital, Chiba, Japan
| | - Takao Morohoshi
- Division of General Thoracic Surgery, Yokosuka-Kyosai Hospital, Kanagawa, Japan
| | - Meinoshin Okumura
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Ichiro Yoshino
- Department of General Thoracic Surgery, Chiba University Graduate School of Medicine, Chiba, Japan
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Abstract
Malignant pleural mesothelioma (MPM) is a rare neoplasm that typically arises from mesothelial surfaces of the pleural cavity. Despite treatment improvements, it carries a dismal prognosis. The majority of patients either have unresectable disease or are not candidates for surgery due to medical comorbidities or old age. For such patients, chemotherapy (CT) represents the gold-standard treatment. To date, combination CT with cisplatin plus pemetrexed represents the most widely used regimen in first-line setting for patients with unresectable MPM. Other first-line options are currently available, including the use of raltitrexed instead of pemetrexed combined with platinum. In this review, we discuss the role of CT in MPM mainly focusing on the results of the trials conducted in first-line setting.
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Affiliation(s)
- Marika Cinausero
- Department of Medicine (DAME), University Hospital of Udine, Udine, Italy.,Department of Oncology, University Hospital of Udine, Udine, Italy.,Department of Oncology, Policlinico S. Orsola-Malpighi, University of Bologna, Bologna, Italy
| | - Karim Rihawi
- Department of Oncology, Policlinico S. Orsola-Malpighi, University of Bologna, Bologna, Italy
| | - Francesca Sperandi
- Department of Oncology, Policlinico S. Orsola-Malpighi, University of Bologna, Bologna, Italy
| | - Barbara Melotti
- Department of Oncology, Policlinico S. Orsola-Malpighi, University of Bologna, Bologna, Italy
| | - Andrea Ardizzoni
- Department of Oncology, Policlinico S. Orsola-Malpighi, University of Bologna, Bologna, Italy
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Abstract
Malignant pleural mesothelioma is an aggressive tumor of the pleura with an overall poor prognosis. Even with surgical resection, for which only a subset of patients are eligible, long term disease free survival is rare. Standard first-line systemic treatment consists of a platinum analog, an anti-metabolite, and sometimes anti-angiogenic therapy, but there is currently no well-established standard therapy for refractory or relapsed disease. This review focuses on efforts to develop improved systemic therapy for the treatment of malignant pleural mesothelioma (MPM) including cytotoxic systemic therapy, a variety of tyrosine kinase inhibitors and their downstream effector pathways, pharmacologic targeting of the epigenome, novel approaches to target proteins expressed on mesothelioma cells (such as mesothelin), arginine depletion therapy, and the emerging role of immunotherapy. Overall, these studies demonstrate the challenges of improving systemic therapy for MPM and highlight the need to develop therapeutic strategies to control this disease.
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Affiliation(s)
- Michael R Mancuso
- Division of Oncology, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Joel W Neal
- Division of Oncology, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
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