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Treatment of Pleural Mesothelioma: ASCO Guideline Update by Hedy L. Kindler et al.
Jan 10, 2025, 19:29

Treatment of Pleural Mesothelioma: ASCO Guideline Update by Hedy L. Kindler et al.

Rami Manochakian, Thoracic medical oncologist at Mayo Clinic, Florida, shared an article on X about Treatment of Pleural Mesothelioma led by Hedy L. Kindler et al.:

Treatment of Pleural Mesothelioma: ASCO Guideline Update

Authors: Hedy L. Kindler et al.

Pleural Mesothelioma

A recent article published in the Journal of Oncology on January 8 highlights updates in the management of pleural mesothelioma (PM).

New randomized data have sparked debates about the role of surgery alongside emerging therapies. The combination of ipilimumab and nivolumab has improved survival, particularly in nonepithelioid cases, prompting questions about the best use of immunotherapy, chemotherapy, and chemoimmunotherapy. Pathologists have redefined the disease, identifying mesothelioma in situ (MIS) and emphasizing the importance of subtype classification for treatment decisions.

The discovery of frequent BAP1 gene mutations in PM patients underscores the need for routine genetic testing due to its impact on prognosis and family risk. These advances have led to updates in the 2018 ASCO mesothelioma guidelines, focusing on the integration of new treatments, diagnostic criteria, and genetic testing into clinical practice. The guideline was developed through a systematic review of evidence, involving a multidisciplinary panel and public feedback, and has been approved for publication after thorough evaluation.

Pleural mesothelioma is a rare cancer of the lung lining, mainly caused by asbestos exposure. Symptoms like chest pain, shortness of breath, and coughing often appear late, making early diagnosis difficult. Treatment options include surgery, chemotherapy, radiation, and immunotherapy, with the combination of ipilimumab and nivolumab showing promise. Advances in research, including the discovery of BAP1 gene mutations, are improving understanding and treatment of this aggressive disease.

Rami Manochakian is a thoracic medical oncologist at Mayo Clinic, Florida. He specializes in thoracic malignancies, including lung cancer, mesothelioma, and thymic tumors, he has dedicated his career to advancing the field of oncology.  He is also recognized as a leader in medical education, serving in various educational roles at Mayo Clinic and national and international medical societies, including ASCO, ALA, and IASLC.