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Malignant Pleural Mesothelioma: Staging and Radiological Response Criteria in Patients Treated with Immune Checkpoint Inhibitors. | LitMetric

AI Article Synopsis

  • Malignant pleural mesothelioma (MPM) is a rare cancer linked to asbestos exposure, with limited treatment options that have historically relied on platinum-based chemotherapy; however, immunotherapy is emerging as a viable alternative.
  • MPM presents unique growth patterns that complicate radiological assessments, especially when combined with non-traditional treatment responses like hyperprogression and pseudoprogression, prompting the need for adapted evaluation criteria such as mRECIST.
  • This review aims to assist radiologists and clinicians in diagnosing and treating MPM, covering current imaging techniques, clinical trials on immunotherapy, and innovations in radiomics and artificial intelligence that could enhance prognosis and treatment strategies.

Article Abstract

Malignant pleural mesothelioma (MPM) is a rare and challenging cancer associated with asbestos fiber exposure, which offers limited treatment options. Historically, platinum-based chemotherapy has been the primary approach, but recent developments have introduced immunotherapy as a promising alternative for the treatment of this disease. Nevertheless, the unique growth patterns and occasionally ambiguous progressive characteristics of MPM make the interpretation of radiological assessments complex. Immunotherapy further complicates matters by introducing unconventional treatment response patterns such as hyperprogression and pseudoprogression. Consequently, there is a growing imperative to integrate the standard RECIST criteria with the mesothelioma-specific mRECIST criteria (version 1.1), as outlined in iRECIST. This comprehensive review is driven by the intent to provide a valuable resource for radiologists and clinicians engaged in the diagnosis, treatment, and monitoring of MPM in the era of immunotherapy. Specifically, the current imaging methods employed for staging and follow-up will be exposed and discussed, with a focus on the technical specificities and the mRECIST 1.1 methodology. Furthermore, we will provide a discussion about major clinical trials related to the use of immunotherapy in MPM patients. Finally, the latest advancements in radiomics, the applications of artificial intelligence in MPM, and their potential impact on clinical practice for prognosis and therapy, are discussed.

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Source
http://dx.doi.org/10.1007/s11523-023-01017-wDOI Listing

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