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Radiotherapy Outcomes in Mesothelioma Linked to Metabolism

radiotherapy outcomesItalian researchers say metabolic markers may hold the key to predicting radiotherapy outcomes in people with mesothelioma.

Metabolism is the process by which cells produce energy. Metabolism is necessary for cancer cells to live. Mesothelioma cells metabolize faster than healthy cells. 

Radiotherapy affects cancer cell metabolism. A new study shows that compounds produced during metabolism may impact radiotherapy outcomes. It suggests that a patient’s metabolic profile – or metabolome – could help doctors choose good candidates for radiation.

Radical Hemithoracic Radiotherapy and Mesothelioma 

Pleural mesothelioma is a rare lung-related cancer caused by asbestos exposure. There is no cure for mesothelioma. Most mesothelioma patients have a combination of therapies. Radiation is one of the methods doctors use to help slow its spread. Radiotherapy outcomes in mesothelioma patients vary widely. 

Radical hemithoracic radiotherapy (RHRT) is intense radiation to one side of the chest. It is a newer therapeutic option to help improve mesothelioma survival. 

The aim of the new Italian study was to see how RHRT affects the metabolome. This understanding could allow them to look at patients’ metabolomic profiles and predict their radiotherapy outcomes.

Predicting Radiotherapy Outcomes with Metabolomics

The new study took place at a cancer center in Aviano, Italy. Nineteen mesothelioma patients had RHRT. They received 50 Gy of radiation in 25 fractions. Doctors evaluated their metabolome before and after treatment. 

Scientists used advanced tests including liquid chromatography and tandem mass spectrometry. The tests measured metabolites in the patients’ blood serum. They compared each patient’s profile to how long they survived. 

About 60 percent of the differences in radiotherapy outcomes were linked to metabolic markers. Changes that had the most impact on survival had to do with amino acids and actyl-carnitines.
“This study highlighted that RHRT can induce profound systemic metabolic effects, some of which may have a significant prognostic value,” writes lead author Emanuela Di Gregorio.  “The integration of metabolomics in the clinical assessment of malignant pleural mesothelioma could be useful to better identify the patients who can achieve the best benefits from the RHRT treatment.”

Radiation Therapy Research in Mesothelioma

Scientists still have a lot to learn about radiation therapy in mesothelioma. But they are making progress. 

Last fall, Canadian scientists released a new study on radiation treatment for pleural mesothelioma. They found that suppressing certain immune system cells can improve radiotherapy outcomes. 

Malignant mesothelioma tends to resist standard cancer treatments, including radiation. New treatments like immunotherapy and tumor treating fields are improving the odds of surviving mesothelioma.


Di Gregorio, E, et al, “Radical Hemithoracic Radiotherapy Induces Systemic Metabolomics Changes That Are Associated with Clinical Outcomes of Malignant Pleural Mesothelioma Patients”, January 2021, Cancers, Online ahead print, https://www.mdpi.com/2072-6694/13/3/508

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