Cutting edge scientific research in mesothelioma is technical, intricate, and can be confusing to most of us. On February 29, 2016, in the journal Nature in the category, Nature Genetics, an article was published entitled: “Comprehensive Genomic Analysis of Malignant Pleural Mesothelioma Identifies Recurrent Mutations, Gene Fusions and Splicing Alterations”. The lead author is Dr. Raphael Bueno.
This research was a collaborative effort involving scientists, physicians, bioinformatics groups, and personnel at the tumor bank at the Brigham and Women’s Hospital. It was supported partly by grants to Dr. Bueno from the National Cancer Institute, the International Mesothelioma Program at Brigham and Women’s Hospital, and Genentech Inc.
The article is written in scientific research form. What the researchers did was analyze tissue from the tumor specimens from 216 cases of malignant pleural mesothelioma, regardless of the type of mesothelioma. Because mesothelioma is a rare cancer, previous studies have been limited by the numbers of tissue samples available. This research had the samples available to study and looked for genetic alterations in the tumors. The article states: “Understanding the genetic alterations that drive MPM [malignant pleural mesothelioma] is critical for successful development of diagnostics, prognostics, and personalized therapeutic modalities.” For example in previous studies, loss of function mutations in gene CDKN2A have been identified in a small number of samples of patients with malignant pleural mesothelioma. The scientific understanding of the mutation of genes in malignant pleural mesothelioma is limited. The article explains: “However, understanding of the mutational landscape of MPM is not yet sufficient to affect classification or treatment strategies.”
Tumors are currently classified as epithelioid, biphasic , and sarcomatoid. This research identified four distinct sub types: sarcomatoid, epithelioid, biphasic-epithelioid (biphasic-E) and biphasic-sarcomatoid (biphasic-S).
The research also identified mutations (changes) in 10 genes and recurrent mutations in several genes. They also recognized changes and alterations in signaling pathways to several genes. This information is vital in furthering research into the treatment and allowing for potentially more treatment options for patients.
What does this all mean to someone diagnosed with malignant pleural mesothelioma today?
Mesothelioma has long been difficult to diagnose and as a result most people do not get diagnosed until the disease is advanced. The diagnosis is difficult to make. Past research has proven that every person’s mesothelioma tumor is as different as every person’s fingerprint. This research clearly identified four distinct molecular subtypes of malignant pleural mesothelioma and recurrent mutations in several genes expressed in the tumor sample. This is a building block towards taking this research and incorporating it into a clinical test or series of tests to tailor patient care to a pathway that is scientifically proven effective. This is an important step in the progress toward a cure for malignant pleural mesothelioma.
One of the potential ways that this research could impact future treatment of mesothelioma patients is in the development of drugs for specific tumor types and gene mutations.
Scientific research and progress is built on previous research. For this research 100 sources were referenced in the article.
Important research like this takes time, resources, collaboration and dedication of many people. For a patient and their families diagnosed with malignant pleural mesothelioma, this research hopefully will make treatment options more targeted and ultimately more successful.
The full text of the article is located here.