bims-mesote 2025-12-21 papers

Issue of 2025–12–21
four papers selected by
Laura Mannarino, Humanitas Research

Front Oncol. 2025 ;15 1698949

Malignant mesothelioma in rare sites: two case reports.

Qiguang Du, Jialu Guo, Zi Zhu, Yutong Zhang, He Cui, Zhongkai Xu, Rang Yang, Wenlong Liang.

Mesothelioma is a rare tumor originating from mesothelial cells in the pleura or other sites. Malignant pleural mesothelioma (MPM) is the most common aggressive type of mesothelioma (accounting for 81%) and carries a poor prognosis (median OS: 1 year). Diagnosing diverse histologic types is challenging. We report two cases: a 72-year-old female with peritoneal mesothelioma demonstrated a remarkable response, with the lesion shrinking from 150×160mm to radiologically undetectable after chemo-immunotherapy, resulting in a sustained complete response. Conversely, a 66-year-old male with MPM exhibited primary platinum resistance, progressing after first-line pemetrexed/lobaplatin and subsequent second-line chemotherapy. Peritoneal mesothelioma responded better to immuno-chemotherapy, while MPM showed platinum resistance. These contrasting disparate outcomes underscore that precise pathology and individualized treatment based on anatomic site are crucial, suggesting that malignant pleural and peritoneal mesothelioma may represent distinct clinical entities.

Keywords: immunotherapy; malignant; mesothelioma; pathological diagnosis; peritoneum; pleura

DOI: https://doi.org/10.3389/fonc.2025.1698949

Cancer Med. 2025 Dec;14(24): e71474

Trends in Pleural Mesothelioma Incidence and Survival in Metropolitan and Nonmetropolitan Areas in the United States.

Alexander J Didier, Charlotte Lennox, Mingjia Li, Jinesh Gheeya, Asrar Alahmadi, Jacob Kaufman, Regan Memmott, Kai He, Peter Shields, Christian Rolfo, David P Carbone, Carolyn Presley, Dwight Owen, Logan Roof.

INTRODUCTION: Pleural mesothelioma (PM) is a rare, aggressive cancer with significant variation in incidence based on geographic factors. Previous studies have highlighted cancer survival disparities between metropolitan and nonmetropolitan populations for other cancers; this data is largely unreported for PM. We aimed to compare incidence trends and cancer-specific survival (CSS) between metropolitan and nonmetropolitan areas in the United States using the Surveillance, Epidemiology, and End Results (SEER) database.
METHODS: We analyzed SEER 18 registries for patients aged ≥ 20 diagnosed with PM between 2004 and 2021. Incidence rates, CSS, and demographic and clinical characteristics were compared between metropolitan and nonmetropolitan areas. Incidence rate ratios (IRRs) were calculated using the Tiwari method. Joinpoint regression was used to assess temporal trends, while Kaplan-Meier and Cox proportional hazard models analyzed survival outcomes.
RESULTS: A total of 8519 PM cases were identified, with 89.3% in metropolitan areas. Nonmetropolitan patients were more likely to be non-Hispanic Black and had lower chemotherapy (p = 0.031) and surgery (p < 0.001) rates. The incidence rate in metropolitan areas declined from 1.4 in 2004 to 0.8 in 2021, while nonmetropolitan areas saw a stable incidence until 2017, followed by a decline to 0.5 in 2021. Metropolitan areas had significantly higher CSS, with 50.3% 1-year CSS by 2020, compared to 27.7% in nonmetropolitan areas. Multivariate analysis indicated a higher hazard of death in nonmetropolitan areas (HR = 1.18, p < 0.001).
CONCLUSION: Significant disparities in PM outcomes between metropolitan and nonmetropolitan areas were revealed. Although both regions experienced a decline in incidence over time, survival outcomes remained worse in nonmetropolitan areas. Patients in nonmetropolitan areas were also less likely to receive chemotherapy and surgery, further contributing to the survival gap. These findings highlight the need for targeted interventions to improve treatment access and enhance survival for nonmetropolitan patients with PM.

DOI: https://doi.org/10.1002/cam4.71474

Cell Death Differ. 2025 Dec 16.

Fibroblast-like cells in mesothelioma can derive from tumor cells.

Jose M Garcia-Manteiga, Eltjona Rrapaj, Francesca Caprioglio, Francesco De Marchis, Andrea Lamarca, Liam S Colley, Angelo Carretta, Daniela Finocchiaro, Francesca Mercalli, Annamaria Molinario, Gianluigi Arrigoni, Renzo Boldorini, Massimo P Crippa, Rosanna Mezzapelle, Marco E Bianchi.

Pleural mesothelioma (PM) is an aggressive cancer that originates from mesothelial cells lining the pleura. To identify the different cell types in mesothelioma and their relationships, we performed single-cell RNAseq analyses of non-malignant pleura biopsies, PM biopsies and PM patient-derived organoids. Gene expression profiles of mesothelial and mesothelioma cells are very similar, suggesting that mesothelioma cells retain most properties of mesothelial cells. Surprisingly, in PM patient-derived organoids mesothelioma cells can acquire a fibroblast-like gene expression profile. Indeed, in most of the original PM biopsies a fraction of cells within the cluster of cancer-associated fibroblasts (CAFs) appear derived from tumor cells, with which they share the same genomic rearrangements. We confirmed by immunohistochemistry, and thus at the protein level, that cancer-derived fibroblast-like cells (CDFs) express smooth muscle actin, as most CAFs do, but have lost the same tumor suppressor proteins as the cognate mesothelioma cells. We propose that mesothelioma cells can become CDFs because they retain the ability of mesothelial cells to differentiate into fibroblasts. CDFs are thus tumor cells with fibroblast-like gene expression associated to tumors, and fulfil the definition of CAFs. CAFs generally support tumor progression, and in most tumors derive from resident fibroblasts or circulating mesenchymal cells. Our finding that a subset of CAFs derive from tumor cells, at least in mesothelioma, challenges current understanding of CAF origin. We suggest that interfering with the mesothelioma-to-CAF transition might offer an avenue to moderate tumor progression and resistance to therapy.

DOI: https://doi.org/10.1038/s41418-025-01639-9

Lung Cancer. 2025 Dec 11. pii: S0169-5002(25)00770-6. [Epub ahead of print]211 108878

Global patterns and trends in mesothelioma incidence: A retrospective cross-sectional study.

Leiwen Fu, Ke Liu, Yang Liu, Yanxiao Gao, Bingyi Wang, Yuxian Sun, Wei Shu, Yujia Ning, Minyi Zhang, Jian Du, Liang Li.

BACKGROUND: Mesothelioma is a rare and aggressive malignancy primarily caused by asbestos exposure; it predominantly affects older adults with a history of occupational contact.
METHODS: This population-based study used the GLOBOCAN 2022 database to estimate mesothelioma incidence and mortality across 185 countries in 2022. Long-term trends were assessed using the Cancer Incidence in Five Continents (CI5) Volume XII and CI5 plus databases. Age-standardised incidence rates (ASIRs) were calculated, and Joinpoint regression analysis was employed to assess trends in mesothelioma ASIRs by estimating the average annual percentage change (AAPC).
RESULTS: In 2022, there were an estimated 30,633 new mesothelioma cases globally, with an ASIR of 0.28 per 100,000. Europe bore the highest burden, accounting for 48.1% of global cases and 48.4% of deaths. A significant positive correlation was observed between the ASIR or age-standardised mortality rate (ASMR) and the Human Development Index. From 2003 to 2017, while mesothelioma incidence decreased in many regions, significant increases were observed among male in Croatia (AAPC: 2.5, 95% CI: 0.3 to 4.8), the Republic of Korea (2.5, 1.2 to 3.7), and Slovenia (1.2, 0.1 to 2.2), as well as in female in Canada (4.5, 1.3 to 7.9). Mesothelioma incidence declined significantly in males in Australia, Belarus, Germany, Israel, the Netherlands, New Zealand, Norway, Turkey, the UK, and in the White population of the USA, as well as in females in Belarus, Germany, and Turkey.
CONCLUSION: Mesothelioma remains a significant global health challenge, characterised by notable geographic and socioeconomic disparities. Sustained public health efforts are required to eliminate asbestos exposure and reduce disease burden, particularly in regions with rising incidence.

Keywords: Average annual percentage change; Epidemiology; Global burden; Incidence; Mesothelioma

DOI: https://doi.org/10.1016/j.lungcan.2025.108878