Two researches recently published by members of Center G. Scansetti provide new advances in the diagnosis and treatment of malignant pleural mesothelioma.
In the first one (Salaroglio IC et al, J Thorac Oncol, doi:10.1016/j.jtho.2019.03.029.) the authors screened 275 patients with an initial clinical diagnosis of pleural effusion, resulting affected by non malignant pleuritis, mesothelioma or secondary tumors metastatizing into the pleura after pathological diagnosis. The immune-populations infiltrating the pleural tissue and the pleural fluid were finely dissected by multi-parameter flow-cytometry, allowing to differentiate the three groups of patients with sensitivity and specificity > 95%, and to predict the overall survival of patients with mesothelioma. This study contributes to set up the basis for new and more accurate diagnostic tests, and for a better prediction of patients' outcome.
In the second work (Milosevic V et al, Int J Cancer, doi:10.1002/ijc.32419) the authors isolated and characterized the mesothelioma initiating cells, responsible for high chemoresistance and recurrence. ABCB5, a drug efflux transporters with poorly known functions, was identified as a key determinant of chemoresistance in initiating cells and as a negative prognostic factor in patients. ABCB5 expression was controlled by interconnected Wnt/IL-1β/IL-8/β-catenin/c-myc-driven autocrine loops. Disrupting these loops may open new therapeutic perspectives that improve the sensitivity towards first-line chemotherapy in mesothelioma.