bims-mesote 2026-01-18 papers

bims-mesote

Biomed News

on Mesothelioma

Issue of 2026–01–18
eight papers selected by
Laura Mannarino, Humanitas Research

Hematogenous dissemination of malignant pleural mesothelioma: An autopsy case of gallbladder metastasis causing obstructive jaundice.
Nintedanib as switch maintenance treatment in malignant pleural mesothelioma (NEMO): A double-blind randomized phase II trial (EORTC-08112-LCG).
Global bibliometric analysis of pleural mesothelioma biomarkers (2002-2024): trends and emerging frontiers.
Hypoxia induces alterations in the volatile signature of pleural mesothelioma cells.
Mesothelioma Contrast Pharmacokinetics: A Feasibility Trial of the Use of Pharmacokinetic Analysis in Small-Volume Pleural Malignancy.
Artificial Intelligence in Pleural Diseases: Current Applications and Next Steps.
Advances in the Basic Sciences in Thoracic Oncology in the Last 20 Years and Their Translational Impact.
Correction to: De novo pyrimidine synthesis is a collateral metabolic vulnerability in NF2-deficient mesothelioma.

Respir Med Case Rep. 2025 ;58 102315

Hematogenous dissemination of malignant pleural mesothelioma: An autopsy case of gallbladder metastasis causing obstructive jaundice.

Shouichi Okamoto, Mariko Shinomiya.

  Malignant pleural mesothelioma (MPM) is an aggressive cancer with poor prognosis. Although hematogenous metastasis is rare, we report an autopsy case in which gallbladder metastasis had caused fatal obstructive jaundice. A 72-year-old man, who had experienced long-term exposure to asbestos, was diagnosed with epithelioid MPM. Despite immuno- and chemotherapy, the disease progressed. Nineteen months later, the patient was admitted with jaundice and renal failure. Imaging showed mild gallbladder wall thickening, but no overt obstruction. The patient died 10 days after admission. An autopsy revealed widespread metastases, including full-thickness gallbladder infiltration and bile stasis in the liver. Acute tubular necrosis of the kidneys and bile protein casts in the renal tubules suggested bile cast nephropathy. The findings of this case suggest that gallbladder metastasis from MPM may cause obstructive jaundice and multi-organ failure, potentially contributing to death. Clinicians should be aware of this rare metastatic pattern when evaluating liver dysfunction in patients with advanced MPM.

Keywords:  Bile cast nephropathy; Gallbladder; Hematogenous dissemination; Malignant pleural mesothelioma; Metastasis; Obstructive jaundice

DOI:  https://doi.org/10.1016/j.rmcr.2025.102315
Lung Cancer. 2026 Jan 09. pii: S0169-5002(26)00001-2. [Epub ahead of print]213 108906

Nintedanib as switch maintenance treatment in malignant pleural mesothelioma (NEMO): A double-blind randomized phase II trial (EORTC-08112-LCG).

Omar Abdel-Rahman, Paul Taylor, Mary O'Brien, Jo Raskin, Claudio Dazzi, Veerle Surmont, Sabrina Zonato, Robin Young, Anne-Claire Toffart, Petra Jankowska, Adam Hassani, Sandrine Marreaud, Luc Boone, Sanjay Popat.

   INTRODUCTION: Pleural mesothelioma (PM) is a lethal malignancy in which angiogenesis and progressive fibrosis drives disease. We evaluated angiogenesis inhibition using nintedanib monotherapy as switch maintenance in patients with PM that completed 4-6 cycles of prior platinum-pemetrexed chemotherapy. The trial was performed in parallel to the LUME-Meso trial in an era prior to routine immune checkpoint inhibitor use, when platinum-pemetrexed was standard of care.
METHODS: This is a triple-blind, placebo-controlled, multicentric, randomized, phase II study. Patients with inoperable PM (all histologies) that completed 4-6 cycles of platinum-pemetrexed chemotherapy were randomized to nintedanib or placebo. The primary endpoint was progression-free survival (PFS). Secondary endpoints included overall survival (OS) and safety.
RESULTS: The trial was prematurely closed due to poor accrual after LUME-meso reported. 37 patients were randomized (18 to nintedanib, 19 to placebo). All analyses performed were descriptive. The median PFS was 3.4 months (95% CI: 2.83-5.82) and 4.6 months (95% CI: 3.65-13.17) for nintedanib and placebo arms, respectively (HR = 2.25, 95% CI: 1.07-4.73) with corresponding median OS of 13.1 months (95% CI: 10.22-26.02) and 38.9 months (95% CI: 18.66-NE) for nintedanib and placebo arms, respectively (HR = 2.38, 95% CI: 1.05-5.43). Two patients (11.1%) in the nintedanib arm experienced ≥ grade 3 treatment-related adverse events. Post progression treatment was balanced between arms but more patients in the placebo arm received immunotherapy (87% vs 54%).
CONCLUSIONS: Descriptive analyses suggest switch maintenance nintedanib does not improve PFS nor OS compared to placebo. Efficacy of the placebo arm may be related to imbalanced immunotherapy usage.

Keywords:  Maintenance; Nintedanib; Pleural mesothelioma; Survival

DOI:  https://doi.org/10.1016/j.lungcan.2026.108906
J Thorac Dis. 2025 Dec 31. 17(12): 10771-10790

Global bibliometric analysis of pleural mesothelioma biomarkers (2002-2024): trends and emerging frontiers.

Shaoyang Huang, Qinghua Duan, Dandan Gu, Wenzhong Yang, Zhengliang Li, Yangdan Wang, Wei Xiong.

   Background: Pleural mesothelioma (PM) is an aggressive malignancy that originates on the mesothelial surface of the pleura, peritoneum, pericardium, and tunica vaginalis. Due to the absence of specific clinical symptoms, early-stage diagnosis occurs in fewer than 5% of cases. Comprehensive assessments of the research landscape on PM biomarkers remain scarce. Therefore, this study employs bibliometric methods to systematically analyze research trends and developments in PM biomarkers, delineate the historical and current research landscape, and identify emerging research frontiers.
Methods: We conducted a literature search for studies on PM biomarkers published between January 1, 2002, and December 31, 2024. Bibliometric analysis and data visualization were performed using VOSviewer and CiteSpace based on literature retrieved from the Web of Science Core Collection (WoSCC).
Results: A total of 662 publications on PM biomarkers, spanning from 2002 to 2024, were included in this study. Our findings reveal a substantial increase in global research on PM biomarkers over the past two decades, with annual publications peaking in 2021. The United States leads in publication volume, while the University of Western Australia ranks as the most prolific institution in this domain. Jenette Creaney, Glen Reid, and Harvey I. Pass are among the most influential authors in this field, while Journal of Thoracic Oncology, PLoS One, and Lung Cancer are the leading journals publishing research on this topic. Biomarkers associated with the diagnosis, treatment, and prognosis of PM remain central research foci in the field.
Conclusions: This study represents the first bibliometric visualization of the research landscape on PM biomarkers, delineating key trends and research boundaries while serving as a valuable reference for scholars.

Keywords:  Citespace; Pleural mesothelioma (PM); Vosviewer; biomarkers; visual analysis

DOI:  https://doi.org/10.21037/jtd-2025-1171
Biomed Pharmacother. 2026 Jan 13. pii: S0753-3322(25)01140-0. [Epub ahead of print]195 118946

Hypoxia induces alterations in the volatile signature of pleural mesothelioma cells.

Eline Janssens, Ellen Heirwegh, An Wouters, Lore Vandermeersch, Jan P Van Meerbeeck, Christophe Walgraeve, Elly Marcq, Kevin Lamote.

  Volatile organic compounds in exhaled breath are promising, non-invasive biomarkers for pleural mesothelioma diagnosis. Studying headspace volatile patterns at the cellular level is valuable to elucidate the biological origin and underlying metabolic pathways of these potential biomarkers. However, it is important to mimic the in vivo physiological conditions as closely as possible. This study investigated the impact of an in vivo-like hypoxic microenvironment on the volatile profile of pleural mesothelioma cells. NCI-H2818 (epithelioid), NCI-H2731 (sarcomatoid) and NKI04 (biphasic) cell lines were cultured under normoxic (21 % O2) and hypoxic (1 % O2) conditions before characterizing their headspace volatile organic compound profiles using gas chromatography-mass spectrometry. A combination of multivariate and univariate statistics was applied to identify significant alterations in volatile patterns between both oxygen conditions and between the prognostically more favorable epithelioid subtype and the less favorable non-epithelioid subtype. Eighty-six volatiles significantly changed between hypoxic and normoxic mesothelioma cells. Increased degradation of aldehydes was observed upon hypoxic exposure alongside increased production of several hydrocarbons, alcohols and ketones. Additionally, different volatiles were significantly altered between the epithelioid and non-epithelioid subtype, with most differential metabolites being specific to hypoxia. This study demonstrated a significant impact of hypoxia on the pleural mesothelioma volatile profile, providing mechanistic insights into how hypoxia alters cellular metabolism in mesothelioma, thereby more closely reflecting patterns observed in patient breath. This stresses the importance of using in vivo-like hypoxic cell culture conditions to identify cancer-related volatile organic compounds for future clinical biomarker development.

Keywords:  Biomarkers; Cell hypoxia; Headspace; Metabolomics; Volatile organic compounds

DOI:  https://doi.org/10.1016/j.biopha.2025.118946
Radiol Cardiothorac Imaging. 2026 Feb;8(1): e250044

Mesothelioma Contrast Pharmacokinetics: A Feasibility Trial of the Use of Pharmacokinetic Analysis in Small-Volume Pleural Malignancy.

Gordon W Cowell, Selina Tsim, David B Stobo, Colin Noble, Catherine A Humphreys, Rosie Woodward, John E Foster, Craig Dick, Kevin G Blyth.

  Purpose To assess the feasibility of dynamic contrast-enhanced (DCE) MRI-derived pharmacokinetic factor acquisition and performance in patients with suspected small-volume pleural malignancy. Materials and Methods This retrospective analysis involved the use of pharmacokinetic parameter computation software for prospectively performed DCE MRI in patients with suspected pleural malignancy performed between January 2013 and October 2016. Pharmacokinetic calculation was performed using pre- and postgadobutrol three-dimensional T1-weighted sequences within a volume of interest. Systematic placement of multiple pleural regions of interest allowed computation of mean pleural volume transfer constant (Ktrans), fractional volume (Ve), and rate constant (kep) per patient. Identification of malignancy involved using cut points calculated from mean Ktrans, Ve, and kep values obtained from macronodular pleural disease. Pharmacokinetic diagnostic performance was assessed individually (Ktrans, Ve, and kep) and in combination with morphology and early contrast enhancement (ECE). Results The study included 58 patients (median age, 76 years [IQR, 70-81 years]; 51 of 58 [88%] male). The primary end point was achieved in 47 of 58 (81%) patients, with successful calculation of pharmacokinetic metrics. A total of 29 of 47 patients (62%) were diagnosed with malignancy with minimal pleural thickening; 24 of 29 (83%) had pleural mesothelioma and 20 of 24 (83%) had stage I disease. Sensitivity (Ktrans, 73%; Ve, 83%; and kep, 87%) and negative predictive value (NPV; Ktrans, 50%; Ve, 60%; and kep, 25%) were calculated using single pharmacokinetic values (P > .05 for each). Combining pharmacokinetic thresholds with morphology and ECE improved sensitivity and NPV to 100% (P = .03 for each factor) but reduced specificity (16.7% for Ktrans/Ve [P = .04]; 5.6% for kep [P = .002]). Conclusion Pharmacokinetic analysis was feasible in small-volume pleural malignancy. Keywords: MR-Dynamic Contrast-enhanced, MR Imaging, Thorax, Pleura, Oncology Supplemental material is available for this article. © RSNA, 2026.

Keywords:  MR Imaging; MR–Dynamic Contrast-enhanced; Oncology; Pleura; Thorax

DOI:  https://doi.org/10.1148/ryct.250044
Thorac Res Pract. 2026 Jan 15.

Artificial Intelligence in Pleural Diseases: Current Applications and Next Steps.

Ferhan Karataş, Öner Dikensoy.

  Pleural diseases pose a significant burden on healthcare systems due to diagnostic challenges and high costs. Artificial intelligence (AI) has the potential to provide faster, more accurate, and more reliable results in the diagnosis of these diseases. This review evaluates the current status of AI technologies in the diagnosis of pleural effusion (PE), malignant PE, tuberculosis pleurisy (TP), pneumothorax, and malignant pleural mesothelioma (MPM). Deep learning algorithms developed for radiological diagnosis provide high sensitivity and specificity in determining the presence and severity of PE. AI models that integrate clinical parameters such as chest computed tomography (CT), positron emission tomography (PET)-CT, and tumour markers in distinguishing between benign and malignant effusions have significantly improved diagnostic accuracy (area under the curve: >0.90). In cytological diagnosis, computer-assisted systems such as Aitrox have demonstrated performance comparable to that of expert cytopathologists in diagnosing malignant effusions. In the diagnosis of TP, AI models outperform conventional diagnostic methods, particularly when combined with laboratory parameters such as adenosine deaminase. Food and Drug Administration-approved AI models are effectively used for the rapid diagnosis of pneumothorax and for emergency interventions. In MPM diagnosis, AI models using PET-CT images and three-dimensional segmentation offer significant advantages in prognostic evaluation and treatment response monitoring. However, large-scale, multi-centre studies are needed to standardise and generalise AI models. In light of these developments, AI may fundamentally change the diagnostic management of pleural diseases.

Keywords:  Artificial intelligence; diagnostic methods; mesothelioma; pleural diseases; pneumothorax; tuberculosis

DOI:  https://doi.org/10.4274/ThoracResPract.2025.2025-6-2
J Thorac Oncol. 2026 Jan;pii: S1556-0864(25)02895-3. [Epub ahead of print]21(1): 41-76

Advances in the Basic Sciences in Thoracic Oncology in the Last 20 Years and Their Translational Impact.

Michele Carbone, Christopher Amos, Richard L Attanoos, Mattia Boeri, Raphael Bueno, Paul A Bunn, Lucian R Chirieac, Benjamin Cooper, Dean Fennell, Francoise Galateau-Salle, Lydia Giannakou, Chandra V Goparaju, Raffit Hassan, Paul Hofman, Mark G Kris, Weimin Mao, Michael Minaai, Tsetsuya Mitsudomi, Thierry J Molina, Luis M Montuenga, Kazuki Nabeshima, Antonio Passaro, Solange Peters, Arun Rajan, David B Richardson, Hilary Robbins, Christian Rolfo, Charles M Rudin, Jonathan M Samet, Arnaud Scherpereel, David S Schrump, Gabriella Sozzi, Emanuela Taioli, Silvia D Visonà, Haining Yang, Yoshie Yoshikawa, An Zhao, Harvey I Pass.

  In this article, we summarize the progress made in lung cancer, mesothelioma, and thymic epithelial malignancy during the period 2005-2025. We enlisted multidisciplinary thoracic oncologic experts to tackle this task. The main focus of the article concerns how basic science with translational impact has improved the diagnosis, prognosis, and therapy of these cancers. During the past 20 years, we have come to the realization that "lung cancer" is a name that encompasses tumors with vast histologic, immune, and genomic differences that in turn influence prognosis and response to therapy. For example, programmed death-ligand 1 levels are being used as an immune signature which guides the use of immunotherapy. There is an 85% higher risk for developing lung cancer among first-degree relatives of patients with lung cancer. Accordingly, an increasing number of lung cancers are being identified in carriers of predisposing germline pathogenic inactivating mutations, suggesting that screening programs for early lung cancer detection may benefit family members. Underscoring the role of genetics, and the importance of germline testing, a different variant of mesothelioma has been identified developing in carriers of inactivating heterozygous germline mutations of BAP1 and of other tumor suppressor genes, including a new variant of mesothelioma caused by fusion genes. These variants of mesothelioma are characterized by specific histologic and molecular genetic alterations. These patients benefit from screening programs as they are at risk of multiple malignancies, their tumors are usually much less aggressive, and they are more responsive to therapy compared with sporadic, asbestos-induced mesotheliomas. Thus, the tailored therapeutic approach that is described here for lung cancer may extend to patients with mesothelioma, rather than the previous "one therapy fits all" approach. Progress in the rare thymic epithelial tumors has been less marked; however, recent insights into the biology of thymic tumors have resulted in the development of clinically relevant interventions.

Keywords:  Genetic predisposition; Lung cancer; Mesothelioma; Thymic malignancies

DOI:  https://doi.org/10.1016/j.jtho.2025.11.002
EMBO Mol Med. 2026 Jan 16.

Correction to: De novo pyrimidine synthesis is a collateral metabolic vulnerability in NF2-deficient mesothelioma.

Duo Xu, Yanyun Gao, Shengchen Liu, Shiyuan Yin, Tong Hu, Haibin Deng, Tuo Zhang, Balazs Hegedüs, Thomas M Marti, Patrick Dorn, Shun-Qing Liang, Ralph A Schmid, Ren-Wang Peng, Yongqian Shu.

DOI: https://doi.org/10.1038/s44321-025-00366-5