bims-mesote 2025-12-28 papers

Issue of 2025–12–28
four papers selected by
Laura Mannarino, Humanitas Research

J Pers Med. 2025 Dec 01. pii: 585. [Epub ahead of print]15(12):

The Role of Radiotherapy After Pleurectomy/Decortication for Malignant Pleural Mesothelioma: State of the Art.

Marco Andolfi, Michele Salati, Majed Refai.

Background: Considering the increased need to deliver adjuvant radiotherapy (RT) after pleurectomy/decortication (P/D) for malignant pleural mesothelioma (MPM) without exceeding the tolerance of the adjacent normal tissue, new advanced RT technologies have been developed. However, radiation to the whole hemithorax presents a challenge because of the increased risk of toxicity occurring with two intact radiosensitive lungs. The aim of this study is to systematically review the literature in order to assess the role of radiotherapy after P/D for MPM, based on the evidence published so far. Methods: We conducted this systematic review according to PRISMA guidelines and registered in an international public register of systematic review (PROSPERO). A PubMed and Cochrane database search was performed to identify articles published from 2005 to 2024 regarding the role of adjuvant radiotherapy after P/D for MPM. We included only level I-III-evidence studies according to the Oxford Centre for Evidence-Based Medicine's guidance. Results: We selected 11 level II studies. Based on published reports, delivery of high-dose external beam 'conventional' RT to the entire hemithorax is not recommended in a P/D setting and hemithoracic intensity-modulated radiotherapy (IMRT) may be considered an encouraging and reasonable therapeutic option, leading to excellent loco-regional control and survival results. Conclusions: Data and experience strongly support that the ideal platform to define potential indication of the adjuvant RT is a multidisciplinary team. Moreover, given the technical difficulty of IMRT treatment, we recommend considering this treatment in experienced centers with dedicated protocols for MPM due to their ability to detect and manage side effects resulting from the disease and the treatment as well as to ensure the best and the latest treatment plan for each patient.

Keywords: adjuvant therapy; intensity-modulated radiotherapy; malignant pleural mesothelioma; pleurectomy/decortication

DOI: https://doi.org/10.3390/jpm15120585

Lung Cancer. 2025 Dec 17. pii: S0169-5002(25)00769-X. [Epub ahead of print]211 108877

Locoregional therapies in advanced and recurrent pleural mesothelioma: A systematic review.

Paolo Ambrosini, Thierry Berghmans, Mario Occhipinti, Valérie Durieux, Paul Van Schil, Arnaud Scherpereel, Andrea Riccardo Filippi, Mariana Brandão.

BACKGROUND: Locoregional therapies, including radiotherapy, surgery and other ablative techniques, are occasionally used as strategies to manage oligorecurrent or oligoprogressive pleural mesothelioma. Yet, their real-world utilization, safety and efficacy remain poorly defined.
METHODS: We conducted a systematic review in accordance with PRISMA guidelines. A search was conducted in MEDLINE, Scopus, Academic Search Premier and ProQuest Central up to June 2025 for retrospective and prospective studies of surgical cytoreduction, radiotherapy, or other local interventions in oligorecurrent or oligoprogressive pleural mesothelioma. Data on patient demographics, treatment protocols, local control (LC), progression-free survival (PFS), overall survival (OS) and toxicity were extracted and synthesized descriptively.
RESULTS: A total of 22 studies, all retrospective, encompassing 234 patients, were included. Radiotherapy series (n = 142 patients) reported one-year LC rates ranging from 73.5 to 100 %, a median PFS of 5.1-8.0 months, a median OS of 26.9-38.0 months and grade 3-4 toxicities in ≤ 13 % of patients. Surgical series of oligorecurrences (n = 67 patients) demonstrated OS ranging from 14.5 to 44.6 months, with rare long-term survivors after distant resections. A single series of percutaneous cryoablation (n = 24 patients) achieved a 90.8 % local recurrence free-survival rate at one year with minimal toxicity; a single radiofrequency ablation case yielded a 24-month PFS.
CONCLUSIONS: Retrospective evidence suggests that locoregional interventions can achieve long-term local control and acceptable safety in selected pleural mesothelioma patients with oligorecurrent or oligoprogressive disease. Prospective trials are warranted to establish optimal patient selection and strategies integrating these approaches into standard care.

Keywords: Locoregional treatment; Mesothelioma; Oligometastatic; Oligorecurrence

DOI: https://doi.org/10.1016/j.lungcan.2025.108877

PeerJ. 2025 ;13 e20503

Near-infrared spectroscopy combined with machine learning for plasma-based discriminant diagnosis of malignant mesothelioma: a retrospective study.

Yixuan Gu, Ruting Wang, Weimin Mao, Zhongjian Chen.

This study developed a novel, non-invasive platform integrating near-infrared spectroscopy (NIRS) with machine learning (ML) to address the critical clinical challenge of misdiagnosing malignant mesothelioma (MM). We analyzed plasma samples from 99 individuals (29 MM, 41 lung cancer (LC), and 29 healthy controls). A support vector machine (SVM) model perfectly discriminated MM from LC (area under the curve (AUC) = 0.827), while a partial least squares (PLS) model differentiated MM from healthy control (HC) with high accuracy (AUC = 1.0). Despite the highly promising results, this single-center study is however limited by a small sample size, inherent to the rarity of MM and the associated difficulties in patient recruitment. Our findings demonstrate the potential of the NIRS-ML platform as a highly accurate tool for improving MM diagnosis and discriminant diagnosis, meriting further validation in larger cohorts.

Keywords: Clinical application; Discriminant diagnosis; Machine learning; Malignant mesothelioma; Near-infrared spectroscopy

DOI: https://doi.org/10.7717/peerj.20503