New Mesothelioma Classification Selects Best Treatment

New Mesothelioma Classification Selects Best Treatment

Scientists have come up with a new way to classify malignant pleural mesothelioma (MPM) that could help treatments to be more successful.

Doctors usually classify MPM based on how it looks under a microscope. But the scientists in this study think that there is more to classifying this cancer than its appearance.

Three Types of Mesothelioma

MPM is an aggressive cancer that grows in the lining of the lungs. It is caused by exposure to asbestos and can be difficult to diagnose and treat.

One common way to diagnose MPM is by taking a sample of the cancer tissue and looking at under a microscope or running certain tests on it. This is called a biopsy and it is considered the most reliable diagnostic tool.

Doctors classify MPM into three different “types”. This classification is based on how the cancer cells look under a microscope. About half of malignant mesothelioma’s are the epithelioid type. About 10% are sarcomatoid. And the remaining 40% of mesothelioma cases are mixed, or biphasic.

Identifying the type of MPM that a patient has is important because it affects the treatment plan their doctor will choose. Epithelioid MPM tends to have a better prognosis while sarcomatoid MPM usually has the worst prognosis.

Selecting Best Treatment

Scientists did a big study called MESOMICS, where they looked at the DNA, RNA, and other molecules in 120 MPM tumors. They found that there is a lot of variation between tumors, and the current classification only explains some of it.

They found that the number of copies of DNA, how the immune system is fighting the cancer, and how certain parts of DNA are modified are also important. This information can help doctors to predict how aggressive the cancer is.

The results of the study can help doctors classify MPM in a way that is more useful for treating patients. They can get a better idea of what kind of treatment might work best for each patient.


Mangiante L, Alcala N, Sexton-Oates A, et al. Multiomic analysis of malignant pleural mesothelioma identifies molecular axes and specialized tumor profiles driving intertumor heterogeneity [published online ahead of print, 2023 Mar 16]. Nat Genet. 2023;10.1038/s41588-023-01321-1. doi:10.1038/s41588-023-01321-1. https://pubmed.ncbi.nlm.nih.gov/36928603/

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