Title :

Euracan/iaslc proposals for updating the histologic classification of pleural mesothelioma: towards a more multidisciplinary approach

Author(s) :

Nicholson, Andrew G. [Auteur]
Sauter, Jennifer L. [Auteur]
Nowak, Anna K. [Auteur]
Kindler, Hedy L. [Auteur]
Gill, Ritu R. [Auteur]
Remy, Martine [Auteur]
Evaluation des technologies de santé et des pratiques médicales - ULR 2694 [METRICS]
METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694
Armato, Samuel G. [Auteur]
Fernandez-Cuesta, Lynnette [Auteur]
Bueno, Raphael [Auteur]
Alcala, Nicolas [Auteur]
Foll, Matthieu [Auteur]
Pass, Harvey [Auteur]
Attanoos, Richard [Auteur]
Baas, Paul [Auteur]
Beasley, Mary Beth [Auteur]
Brcic, Luka [Auteur]
Butnor, Kelly J. [Auteur]
Chirieac, Lucian R. [Auteur]
Churg, Andrew [Auteur]
Courtiol, Pierre [Auteur]
Dacic, Sanja [Auteur]
De Perrot, Marc [Auteur]
Frauenfelder, Thomas [Auteur]
Gibbs, Allen [Auteur]
Hirsch, Fred R. [Auteur]
Hiroshima, Kenzo [Auteur]
Husain, Aliya [Auteur]
Klebe, Sonja [Auteur]
Lantuejoul, Sylvie [Auteur]
Moreira, Andre [Auteur]
Opitz, Isabelle [Auteur]
Perol, Maurice [Auteur]
Roden, Anja [Auteur]
Roggli, Victor [Auteur]
Scherpereel, Arnaud [Auteur]
Centre d'Infection et d'Immunité de Lille (CIIL) - U1019 - UMR 8204
Centre d’Infection et d’Immunité de Lille - INSERM U 1019 - UMR 9017 - UMR 8204 [CIIL]
Tirode, Frank [Auteur]
Tazelaar, Henry [Auteur]
Travis, William D. [Auteur]
Tsao, Ming Sound [Auteur]
Van Schil, Paul [Auteur]
Vignaud, Jean Michel [Auteur]
Weynand, Birgit [Auteur]
Cree, Ian [Auteur]
Rusch, Valérie W. [Auteur]
Girard, Nicolas [Auteur]
Galateau-Salle, Françoise [Auteur]

Journal title :

Journal of thoracic oncology . official publication of the International Association for the Study of Lung Cancer

Abbreviated title :

J Thorac Oncol

Publication date :

2019-09-20

ISSN :

1556-1380

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [en]

BACKGROUND: Molecular and immunologic breakthroughs are transforming the management of thoracic cancer, although advances have not been as marked for malignant pleural mesothelioma (MPM) where pathologic diagnosis has been ...
Show more >BACKGROUND: Molecular and immunologic breakthroughs are transforming the management of thoracic cancer, although advances have not been as marked for malignant pleural mesothelioma (MPM) where pathologic diagnosis has been essentially limited to three histologic subtypes. METHODS: A multidisciplinary group (pathologists, molecular biologists, surgeons, radiologists and oncologists), sponsored by EURACAN/IASLC met in 2018, to critically review the current classification. RESULTS: Recommendations include: 1) classification should be updated to include architectural patterns, and stromal and cytologic features that refine prognostication 2) subject to data accrual, malignant mesothelioma in situ could be an additional category, 3) grading of epithelioid MPMs should be routinely undertaken, 4) favorable/unfavorable histologic characteristics should be routinely reported, 5) clinically relevant molecular data (PD-L1, BAP1, CDKN2A) should be incorporated into reports, if undertaken, 6) other molecular data should be accrued as part of future trials 7) resection specimens (i.e. extended pleurectomy/decortication and extrapleural pneumonectomy) should be pathologically staged with smaller specimens being clinically staged, 8) ideally, at least 3 separate areas should be sampled from the pleural cavity, including areas of interest identified on pre-surgical imaging, 9) image-acquisition protocols/imaging terminology should be standardized to aid research/refine clinical staging, 10) multidisciplinary tumor boards should include pathologists to ensure appropriate treatment options are considered, 11) all histologic subtypes should be considered potential candidates for chemotherapy, 12) patients with sarcomatoid or biphasic mesothelioma should not be excluded from first line clinical trials unless there is a compelling reason, 13) tumor subtyping should be further assessed in relation to duration of response to immunotherapy, 14) systematic screening of all patients for germline mutations is not recommended, in the absence of a family history suspicious for BAP1 syndrome. CONCLUSIONS: These multidisciplinary recommendations for pathology classification and application will allow more informative pathologic reporting and potential risk stratification, to support clinical practice, research investigation and clinical trials.Show less >

Language :

Anglais

Audience :

Internationale

Popular science :

Non

Administrative institution(s) :

CHU Lille
CNRS
Inserm
Institut Pasteur de Lille
Université de Lille

Collections :

• METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694

Submission date :

2019-12-09T16:47:50Z