This Subset of Mesothelioma Patients May Live Longer

A group of mesothelioma experts from around the world has identified a set of criteria linked with longer mesothelioma survival.

They are hopeful that their research will help doctors identify mesothelioma patients who fall into this longer-living group and direct them to the special care they may need to stay healthier, longer.

In a new article in the Journal of Clinical Oncology, some of the world’s leading mesothelioma researchers, including scientists from Stanford University, New York University Langone Medical Center, The University of Hawaii, the Hyogo College of Medicine in Japan, and the Mesothelioma Applied Research Foundation, say mesothelioma patients who meet these criteria should consider genetic counseling and cancer screening.

Criteria for Improved Mesothelioma Outcomes

The report was based on the cases of 79 mesothelioma patients, identified over the course of 7 years, who met the criteria identified by the study.  

These patients all

• had other cases of malignant mesothelioma in their families,
• had cancers that have been linked to BAP1 mutation (certain kinds of skin, eye, or kidney cancer) OR had had several different kinds of cancer, or
• were younger than 50 when they were diagnosed with mesothelioma.

Forty-three of these patients were found to have BAP1 mutations — sometimes referred to as BAP1 tumor predisposition syndrome — and another 12 had mutations on other genes linked to cancer.

Among the 43 with BAP1 mutations, the median age at diagnosis was 54 and the median survival was 5 years. In those with no BAP1 mutations, the median age at diagnosis was just 45 but the median survival was 9 years.

Mesothelioma Patients Experienced Longer Survival

Whether or not they were found to have BAP1 mutations or some other kind of genetic anomaly, all of the patients who met the criteria laid out in the study experienced much longer survival than is typical of mesothelioma.

“When compared with patients with malignant mesotheliomas in the SEER cohort [national database], median age at diagnosis (72 years), median survival for all MM stages (8 months), and stage I (11 months), were significantly different from the 79 patients with MM in the current study,” states the report.

Most were Unaware of Asbestos Exposure

Even though asbestos is the primary cause of mesothelioma, even among patients with genetic predisposition, only 28% of the patients in the study reported being aware of possible asbestos exposure.

One bright spot for these patients is that scientists are actively developing new, targeted cancer therapies specifically for people with BAP1 and certain others kinds of genetic mutations.  

“These patients and their relatives are susceptible to development of additional cancers,” concludes the report summary. “Therefore, genetic counseling and cancer screening should be considered.”

An estimated 2,500 people are diagnosed with mesothelioma in the US each year. Most are unaware of the disease until it is in its advanced stages, when life expectancy is often less than a year.

Source:

Pastorino, S, et al, “A Subset of Mesotheliomas With Improved Survival Occurring in Carriers of BAP1 and Other Germline Mutations”, October 30, 2018, Journal of Clinical Oncology, Epub ahead of print, http://ascopubs.org/doi/10.1200/JCO.2018.79.0352