Gaining New Insights into Mesothelioma

The five-year survival rate for patients diagnosed with mesothelioma is between five and ten percent. Although aggressive surgery can help some patients with early-stage mesothelioma, current treatments for patients with more advanced mesothelioma are not effective.

Physician-researchers from the International Mesothelioma Program at Brigham and Women’s Hospital (BWH), one of the largest mesothelioma treatment and research programs in the world, have been studying the disease to better understand its biology and develop treatment strategies to target its vulnerabilities.

In a comprehensive genomic analysis using more than 200 malignant pleural mesothelioma (MPM) tumor samples, BWH investigators and scientists from Genentech discovered previously unknown genetic alterations, including some that may be directly linked to therapeutic approaches and others that may improve diagnostics, screening, and predictions about outcomes for patients. The team’s results were published in Nature Genetics.

The study, led by Raphael Bueno, MD, chief of the Division of Thoracic Surgery at BWH and co-director of the BWH Lung Center, compared the DNA and RNA from normal tissue to the cancerous tissue. The researchers uncovered more than 2,500 alterations and identified 10 significantly mutated genes.

  • Genetic alterations suggest that targeted therapies, such as a BCR-ABL-1 inhibitor, could be matched to a patient’s tumor.
  • Certain alterations and the presence of particular immune targets may serve as better markers to help pathologists accurately diagnose mesothelioma and predict which patients will have poor or better outcomes.
  • An analysis of the tumors for expression of PD-L1, a cancer immunotherapy target, found that sarcomatoid histology, a subtype of the mesothelioma, may be a good candidate for anti-PD-L1 therapy.

Experts in the International Mesothelioma Program plan to continue this important research through investigator-sponsored trials evaluating the potential use of cancer immunotherapies for the treatment of mesothelioma.

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