bims-mesote Biomed News
on Mesothelioma
Issue of 2025–06–15
six papers selected by
Laura Mannarino, Humanitas Research



  1. Pulm Ther. 2025 Jun 11.
      In this concise article, we give a current overview of the practical approach to diagnosing pleural mesothelioma (PM). PM is a rare, incurable, aggressive cancer almost exclusively related to previous asbestos exposure. We begin by outlining the general approach to pleural malignancy. The focus then shifts to pleural mesothelioma (PM), with discussions on cytological analyses, a direct-to-thoracoscopy approach, specialist services, and future directions. This narrative review aims to provide an updated, practical overview of current and emerging diagnostic strategies.
    Keywords:  Cytology; Malignant pleural effusion; Pleural malignancy; Pleural mesothelioma; Thoracoscopy
    DOI:  https://doi.org/10.1007/s41030-025-00301-6
  2. Future Oncol. 2025 Jun 12. 1-11
       BACKGROUND: Pleural mesothelioma (PPM) is a rare aggressive cancer linked to asbestos exposure, with limited treatment options, especially in low-resource settings. While immune checkpoint inhibitors show promise, access remains limited in many countries.
    METHODS: This prospective study was conducted at Ain Shams University Hospital from November 2022 to December 2024. 42 patients with unresectable PM and no progression after 4-6 cycles of platinum-pemetrexed chemotherapy were randomized 1:1 to receive switch-maintenance gemcitabine (1000 mg/m2 on days 1 and 8 every 21 days) or best supportive care (BSC). Progression-free survival (PFS), overall survival (OS), and toxicity (Common Terminology Criteria for Adverse Events CTCAE v5.0) were assessed.
    RESULTS: Maintenance gemcitabine significantly improved PFS in unresectable PM (8.9 vs. 5.2 months, p = 0.022), confirmed in univariate analysis (HR = 0.505, p = 0.040) but not multivariate (p = 0.069). OS also favored gemcitabine (16.2 vs. 13.4 months, p = 0.138). Multivariate analysis linked gemcitabine (p = 0.043), females, cisplatin use, and partial response to initial therapy with better OS, while ECOG II and occupational exposure predicted worse OS. Adverse events were manageable.
    CONCLUSION: Maintenance gemcitabine significantly improved PFS and was well tolerated, offering a practical and affordable treatment option for PM.
    CLINICAL TRIAL REGISTRATION: www.clinicaltrials.gov identifier is NCT05660616.
    Keywords:  Pleural mesothelioma; gemcitabine; maintenance therapy; overall survival; platinum-pemetrexed; progression-free survival; resource-limited settings
    DOI:  https://doi.org/10.1080/14796694.2025.2516412
  3. Diagnostics (Basel). 2025 May 24. pii: 1323. [Epub ahead of print]15(11):
      Pleural mesothelioma (PM) is a rare disease, which is going to be a global medical concern in the 21st century, because of its aggressiveness, late diagnosis, and insufficient therapies. This review seeks to enhance the comprehension of medical professionals regarding the risk factors and environmental influences that contribute to the development of the disease, as well as its underlying mechanisms. In addition, we aim to provide a schematic yet thorough overview of diagnostic techniques in PM, emphasizing the significance of the immunohistochemical markers BAP1 and MTAP, with the latter serving as an almost ideal surrogate for the gold-standard diagnostic approach, FISH p16/CDKN2A deletion. The scientific world is grappling with BAP1, MTAP, and the tumour inflammatory microenvironment, because they are the key for personalized treatments and palliative care in this disease. Considering that the survival rate for patients with PM seldom surpasses five years, every moment is significant. Therefore, our article also highlights recent advancements in clinical assessments related to prognostic scoring and treatment options. PM is a complex disease, with gradual progression over decades, which requires further investigation covering the prevention, mutations, diagnosis and treatment.
    Keywords:  BAP1; MTAP; asbestos; diagnosis; immunohistochemical markers; immunohistochemistry; inflammatory microenvironment; pleural mesothelioma; prognosis
    DOI:  https://doi.org/10.3390/diagnostics15111323
  4. Front Pharmacol. 2025 ;16 1577232
       Background: Malignant pleural mesothelioma (MPM) is a rare type of tumor closely associated with asbestos exposure. Increasing evidence shows that high immuno-heterogeneity reduces the therapeutic efficacy of MPM. At present, good biomarkers to screen immunodominant populations and predict the efficacy of immunotherapy are lacking.
    Methods: In this study, expression data from TCGA, GSE2459, GSE51024, and GSE29354 were integrated for model construction. An eight-gene risk score model (FLI1, IL32, FUCA1, CCR2, PSMB10, CCL5, WT1, and KRT5) was constructed using CIBERSORT, weighted gene co-expression network analysis, Cox regression analysis, differentially expressed gene analysis, and protein-protein interaction network. The K-M survival analysis was used to evaluate the prediction ability of the risk score model. The TIDE database and Oncology Drug Sensitivity Genomics database were used to assess the predictive power of risk score models for treatment. In addition, the expression of the key gene in para-carcinoma tissue and MPM samples were detected by Immunohistochemistry. Patient clinical information was employed to evaluate the relationship between key genes and patient survival. Finally, the biological functions of the key gene were examined by in vitro and in vivo experiments.
    Results: The score model was used to divide patients with MPM into low- and high-risk groups. The high-risk group was characterized by a survival disadvantage, and they were less sensitive to immunotherapy. Clinical data suggest that FUCA1, which is a key gene in the model, is an independent risk factor for predicting the prognosis of patients with MPM. A series of experiments demonstrated that FUCA1 expression was negatively correlated with the proliferation, invasion and migration abilities of MPM cells. Further studies revealed that FUCA1 inhibited epithelial-mesenchymal transition in MPM cells by regulating the PI3K-AKT signaling pathway.
    Conclusion: The risk score model provides a new perspective for screening potential populations to benefit from immunotherapy and predicting their survival. FUCA1 may be a potential prognostic biomarker and promising therapeutic target for patients with MPM.
    Keywords:  EMT; FUCA1; immune cell; machine learning; malignant pleural mesothelioma
    DOI:  https://doi.org/10.3389/fphar.2025.1577232
  5. J Immunother Cancer. 2025 Jun 10. pii: e009482. [Epub ahead of print]13(6):
       BACKGROUND: Chest malignancies such as non-small cell lung cancer (NSCLC) or pleural mesothelioma (PM) have an ominous prognosis. Photodynamic therapy (PDT) of NSCLC and PM improves patient survival, but the precise underlying mechanism remains unknown. Here, we hypothesized that low-dose PDT (L-PDT) alters the expression of tumor endothelial cell adhesion molecules favoring immune cell recruitment and tumor control. We explored this hypothesis in two mouse models of NSCLC and PM. We validated our findings in 82 PM patient samples.
    METHODS: We assessed, in C56BL/6 mice bearing 344SQ-NSCLC and in BALB/c mice bearing AB12-PM, how L-PDT (400 μg/kg Visudyne administered intravenously, irradiance: 50 mW/cm2, light dose: 10 J/cm2) affected tumor growth, modulated the tumor immune microenvironment and the expression of endothelial selectin cell adhesion molecule (E-selectin) using real-time multiphoton imaging, immunofluorescence staining and flow cytometry. We then blocked E-selectin, canonical nuclear factor kappa B (NF-κB) pathway or selectively depleted CD8+ lymphocytes with dedicated peptides/antibodies in mouse models to evaluate the effect of L-PDT on tumors. Finally, we assessed in 82 PM patient samples the correlation between vascular E-selectin and CD8+ lymphocyte content by immunofluorescence staining of tissue sections and their association with patient survival.
    RESULTS: L-PDT induced vascular E-selectin in both NSCLC and PM, which enhanced granzyme B+/CD3+/CD8+ lymphocyte infiltration and improved tumor control. Blockade of E-selectin or immunodepletion of CD8+ lymphocytes abrogated the L-PDT-mediated cancer regression. Moreover, canonical NF-κB pathway blockade impaired enhanced vascular E-selectin expression and CD8+ T cells infiltration in tumors following L-PDT. In human malignant pleural mesothelioma samples, we found a correlation between vascular E-selectin and CD8+ T cell infiltration, which was associated with improved patient outcome.
    CONCLUSION: L-PDT remodels the vasculature of chest tumors and favors a cytotoxic immune microenvironment promoting tumor control. This approach could complement current immunotherapy approaches in these malignancies.
    Keywords:  immune checkpoint inhibitor; immunotherapy; lung cancer; mesothelioma; surgery
    DOI:  https://doi.org/10.1136/jitc-2024-009482
  6. JTO Clin Res Rep. 2025 Jun;6(6): 100802
       Introduction: There is a paucity of real-world associations between EQ-5D-generated health utility scores (HUS), symptoms as measured by the Edmonton Symptom Assessment System (ESAS), and the patient-reported outcomes version of the common terminology criteria for adverse events (pro-CTCAE), and survival in patients with advanced Malignant Pleural Mesothelioma (aMPM).
    Methods: Clinico-demographic variables and treatment information were captured retrospectively in patients diagnosed with aMPM between January 2004 and February 2021 at Princess Margaret Cancer Centre. Quality of life outcomes were measured using HUS, ESAS, and pro-CTCAE scales, by stable versus progressive disease and line-of-treatment states. Survival by mean ESAS scores were analyzed using the Kaplan-Meier method.
    Results: Of the 262 patients, the median age was 69 years (interquartile range: 62-74), 77% were male individuals, 52% were ever-smokers, 67% were the epithelioid-subtype, and 62% received first-line systemic therapy for advanced disease. The mean baseline HUS at diagnosis was 0.68 (95% confidence interval: 0.62-0.74) with most symptoms consisting of pain, dyspnea, and fatigue. Pooled ESAS physical and psychological scores changed significantly with disease state: the mean scores were worst at baseline, improved with stable or responding disease (physical, p < 0.001; psychological, p < 0.001), and worsened at progressive disease (physical: p < 0.001; psychological, p < 0.001). Similar trends were seen in HUS and pro-CTCAE symptom severity/frequency. Patients with high baseline ESAS physical symptom burden had inferior overall survival (median = 8.9 [high] versus 12.6 months [low], p = 0.022). Weak-to-moderate correlations were observed between most ESAS domains and HU and between pro-CTCAE domains and HU. The strongest domain correlations were with well-being, shortness of breath, tiredness, and depression domains.
    Conclusions: Baseline quality of life burden is high in patients with aMPM and is well captured by both EQ-5D and ESAS Individual ESAS and pro-CTCAE domains reported low/moderate correlations with HUS, reflecting the inability of one symptom to predict the entire disease state, thus paving the way for future mapping studies. The baseline physical symptom burden (ESAS) was prognostic of survival.
    Keywords:  Advanced mesothelioma; Health utility; Patient-reported outcomes; Quality of life
    DOI:  https://doi.org/10.1016/j.jtocrr.2025.100802