Malignant Pleural Mesothelioma (MPM) is a Highly Lethal Neoplasm

Another interesting study is called, "Validation of Genomics-Based Prognostic Tests in Malignant Pleural Mesothelioma" by Gavin J. Gordon, Graham N. Rockwell, Paul A. Godfrey, Roderick V. Jensen, Jonathan N. Glickman, Beow Y. Yeap, William G. Richards, David J. Sugarbaker and Raphael Bueno - Clinical Cancer Research June 2005 11; 4406.  Here is an excerpt: "Abstract - Purpose: Malignant pleural mesothelioma (MPM) is a highly lethal neoplasm with limited pretreatment prognostication strategies. In this report, we examine the accuracy of a previously proposed prognostic test in an independent cohort of MPM patients. This test uses simple ratios of gene expression levels to provide a novel prognostication scheme.

Experimental Design: Gene expression data using high-density oligonucleotide microarrays (∼22,000 genes) were obtained for a new cohort of human MPM tumors from patients undergoing similar treatments (n = 39). The relative expression levels for specific genes were also determined using real-time quantitative reverse transcription-PCR. We also used a subset of these tumors associated with widely divergent patient survival (n = 23) as a training set to identify new treatment-specific candidate prognostic molecular markers and gene ratio–based prognostic tests. The predictive nature of these newly discovered markers and gene ratio–based prognostic tests were then examined in an independent group of tumors (n = 52) using microarray data and quantitative reverse transcription-PCR.

Results: Previously described MPM prognostic genes and gene ratio–based prognostic tests predicted clinical outcome in 39 independent MPM tumor specimens in a statistically significant manner. Newly discovered treatment-specific prognostic genes and gene ratio–based prognostic tests were highly accurate and statistically significant when examined in an independent group of 52 tumors from patients undergoing similar treatment.

Conclusions: The data support the use of gene ratios in translating gene expression data into easily reproducible, statistically validated clinical tests for the prediction of outcome in MPM."

Another interesting study is called, "Assessing Quality of Life During Chemotherapy for Pleural Mesothelioma: Feasibility, Validity, and Results of Using the European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire and Lung Cancer Module" - Journal of Clinical Oncology, Vol 22, No 15 (August 1), 2004: pp. 3172-3180 by Anna K. Nowak, Martin R. Stockler, Michael J. Byrne From the National Health and Medical Research Council Clinical Trials Centre, University of Sydney; Sydney Cancer Centre–Royal Prince Alfred and Concord Hospitals, Sydney; and Sir Charles Gairdner Hospital, Perth, Australia.  Here is an excerpt: "ABSTRACT - PURPOSE: To assess the feasibility and validity of using the European Organization for Research and Treatment of Cancer (EORTC) Core Quality of Life Questionnaire (QLQ-C30) and Lung Cancer Module (QLQ-LC13) to describe health-related quality of life (HRQL) in patients with pleural mesothelioma undergoing combination chemotherapy, to identify the most impaired aspects of HRQL, and to assess the impact of chemotherapy on HRQL.

PATIENTS AND METHODS: Fifty-three patients received cisplatin on day 1 and gemcitabine on days 1, 8, and 15 of a 28-day cycle for a maximum of six cycles. HRQL was assessed using the EORTC QLQ-C30 and QLQ-LC13.

RESULTS: Compliance was 100% at baseline but subsequently decreased. At baseline, role function and social function were the most impaired domains, and the worst-rated symptoms were fatigue, dyspnea, pain, insomnia, appetite loss, and cough. Dyspnea, pain, insomnia, and cough improved with chemotherapy, although functional domains and chemotherapy-related symptoms deteriorated. Fatigue remained unchanged. Few patients reported hemoptysis. Functional domains and symptoms scales from the QLQ-C30 demonstrated predictive validity for survival. The predictive value of QLQ-LC13 pain scores was improved by combining three pain items into a single score. Dyspnea scores were correlated strongly with lung function as measured by forced vital capacity.

CONCLUSION: This study supports the validity of the EORTC QLQ-C30 and LC13 as outcome measures for trials of chemotherapy in mesothelioma. Although the most prominent symptoms reported were concordant with clinical experience, impairments in role and social function and insomnia were worse than expected. Future research should focus on how best to apply, analyze, and interpret existing, validated HRQL instruments in mesothelioma research and practice, not on the development of new ones."

Another interesting study is called, "Mesothelioma of the atrioventricular node." By K Nishida, G Kamijima, T Nagayama - Br Heart J 1985;53:468-470 – Here is an excerpt: "
Abstract - A patient with Mobitz type 2 heart block caused by a mesothelioma of the atrioventricular node died of a subarachnoid haemorrhage at the age of 33 two years after implantation of a permanent pacemaker. Mesothelioma of the atrioventricular node is rare, and reported cases have all been diagnosed post mortem. Mesothelioma of the atrioventricular node should be considered in the differential diagnosis of heart block in children or young adults. This is the first case to be reported in Japan."

Summary:   Malignant pleural mesothelioma is an aggressive primary neoplasm for which early detection and accurate staging are known diagnostic challenges