Sarcomatoid mesothelioma: future advances in diagnosis, biomolecular assessment, and therapeutic options in a poor-outcome disease

Tumori. Mar-Apr 2016;102(2):127-30. doi: 10.5301/tj.5000364. Epub 2015 Jun 5.

Abstract

Malignant pleural mesothelioma (MPM) is the most frequent pleural neoplasm, with asbestos exposure as one of the recognized carcinogen agents, causative in 80% of cases. The prognosis is poor; median survival of untreated cases is 6-9 months, with fewer than 5% of patients surviving 5 years. Sarcomatoid mesothelioma (SM) represents the subtype with the worst outcome and median survival ranging from 3.5 to 8 months. In the last few years, an accurate differentiation between the subtypes of MPM has become a crucial issue, due to differences in chemosensitivity and clinical outcome, and several studies have evaluated different immunohistochemical markers to better define the diagnosis. The different and worse outcome of patients with SM and, in general, nonepithelioid subtypes makes it intriguing to select these cases to better study the biomolecular profile in order to find factors linked to prognosis and/or predictive of therapeutic response. Considering recent studies on miRNA and genetic mapping, further investigation of this rare subtype might represent a field for basic and clinical-translational research providing for more tailored therapies.

Publication types

  • Review

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Asbestos / toxicity
  • Carcinogens / toxicity
  • Humans
  • Lung Neoplasms / diagnosis*
  • Lung Neoplasms / drug therapy
  • Lung Neoplasms / genetics*
  • Lung Neoplasms / mortality
  • Lung Neoplasms / pathology
  • Mesothelioma / diagnosis*
  • Mesothelioma / drug therapy
  • Mesothelioma / genetics*
  • Mesothelioma / mortality
  • Mesothelioma / pathology
  • MicroRNAs / analysis*
  • Neoplasm Staging
  • Pleural Neoplasms / diagnosis*
  • Pleural Neoplasms / drug therapy
  • Pleural Neoplasms / genetics*
  • Pleural Neoplasms / mortality
  • Pleural Neoplasms / pathology
  • Predictive Value of Tests
  • Prognosis
  • Survival Rate

Substances

  • Carcinogens
  • MIRN17 microRNA, human
  • MIRN205 microRNA, human
  • MIRN30 microRNA, human
  • MicroRNAs
  • Asbestos

Supplementary concepts

  • Mesothelioma, Malignant