Mesothelioma vs. Radiological Pleural Metastases

 Mesothelioma vs. Radiological Pleural Metastases.Real-world analysis of patients with progressive malignant mesothelioma (MPM) receiving nivolumab, an anti-PD-1 monoclonal antibody, demonstrated promising activity in phase II clinical trials. Patients participating in the Extended Access Program sponsored by BMS from both Erasmus Medical Center and the Netherlands Cancer Institute were included in the analysis.

How were patients with mesothelioma treated versus pleural metastases.

More than 100 patients with mesothelioma versus radiologist pleural metastases treated with nevolumab were identified and evaluated by computed tomography. The overall response rate (ORR) and median survival (mOS) were found to be lower than those seen in clinical trials of checkpoint inhibitors. In the 10 patients who achieved a partial response, MOS was significantly improved and no deaths were reported after 14 months of follow-up. PD-L1 positivity was found to be associated with improved ORR and may represent a useful biomarker for nivolumab therapy. This interview was conducted during the 2021 virtual meeting of the International Lung Cancer Conference (IASLC).

Is mesothelioma disease versus pleural metastases malignant.

Malignant pleural mesothelioma (MPM) is a rare malignant tumor of the pleura that commonly affects individuals occupationally exposed to asbestos through a variety of industries. MPM offers many CT features similar to more common pleural diseases such as diffuse pleural malignancy.

How was the diagnosis made for mesothelioma versus pleural metastases.

Chest CT scans of 55 patients with pleural malignancies including MPM and metastatic pleural malignancy were evaluated in this retrospective study. The pathologist made the specific diagnosis based on immunohistochemistry. A chest radiologist unaware of the pathological diagnosis noted all CT scans. Many factors including pleural thickening, pleural effusion, lobar notch thickening, contralateral extension, hemifacial contracture, parenchymal involvement (infiltration, nodules, fibrosis), pleural mediastinal involvement, lymphadenopathy, extradural invasion (liver, chest wall, diaphragm, intraperitoneal), and pericardial involvement was examined. Data analysis was performed using SPSS version 16, and the ability of CT to differentiate malignant pleural mesothelioma from metastatic pleural disease was examined.

How was the evaluation of mesothelioma disease versus radiographic pleural metastases for males and females.

A total of 29 males and 26 females were evaluated in the mesothelioma versus pleural metastases radiology study. Based on the pathology, 17 MPM and 38 metastatic pleural malignancies were diagnosed. According to the CT study, about 82% of patients with MPM mesothelioma versus radiological pleural metastases and about 79% of patients with metastatic pleural disease were correctly diagnosed by a radiologist. The most common findings suggestive of MPM were pleural thickening (88.2%), localized effusion (58.8%), interstitial fissure thickening (47.1%). While free pleural effusion (71.7%), parenchymal infiltration (65.8%) and pleural effusion (63.2%) were the most prevalent among the metastatic cases.