S15 Evolution of mesothelioma following initial biopsies showing benign pleural inflammation: a meta-analysis

• Published in: Thorax Vol. 76; no. Suppl 2; p. A14
• Main Authors: Ferguson, KJ, Blyth, KG, Neilson, M
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd and British Thoracic Society 08.11.2021; BMJ Publishing Group LTD
• Subjects: Asbestos; Biopsy; Feasibility studies; Mesothelioma; Meta-analysis; Probing the pleural space; Site selection
• ISSN: 0040-6376; 1468-3296
• DOI: 10.1136/thorax-2021-BTSabstracts.21

IntroductionMalignant Pleural Mesothelioma (MPM) is typically preceded by chronic pleural inflammation, providing a unique window for translational research. Within the PREDICT-Meso International Accelerator Network, the Meso-ORIGINS (Mesothelioma Observational study of RIsk prediction and Generation of benign-meso tissue pairs, Including a Nested MRI Sub-study) study will recruit 500 asbestos-exposed patients with initial benign pleural biopsies. All will undergo detailed surveillance at ~20 UK sites, including repeat biopsies in the minority who evolve into MPM. These paired tissue samples will be used to define new therapeutic targets and develop new pre-clinical models for drug screening. Here, we integrate data from the 4-centre Meso-ORIGINS feasibility study regarding Benign-MPM evolution rate, with previously published literature. This data is being used to finalise the Meso-ORIGINS study design and site selection.MethodsStudies were identified on PubMed using the search terms ‘non-specific pleuritis’, ‘benign fibrinous pleurisy’ and ‘mesothelioma’. The following data were extracted: publication year, number of benign pleuritis cases, number of subsequent evolutions, cohort entry criteria (including biopsy technique, asbestos exposure), median follow-up, country and region of origin, and study design (retrospective or prospective). A random effects meta-analysis model was used to analyse the primary outcome; MPM evolution rate, with I2 used to assess between-study heterogeneity.Results11 studies were identified. These data were combined with Meso-ORIGINS feasibility study data (42 evolutions from 257 benign cases (16%)),1 generating a total of 189 evolutions from 2086 benign cases. The summary point estimate of MPM evolution was 6% (95% CI 4–10), see figure 1, which also confirms significant between study heterogeneity (I280%, p<0.01).Abstract S15 Figure 1ConclusionThe Benign-MPM evolution rate varies in the reported studies, which show high inter-study heterogeneity. Sub-group analyses of individual study factors associated with higher MPM evolution rates are ongoing, including biopsy techniques (LAT vs VATS), median follow-up, geographical area in relation to MPM incidence and asbestos exposure frequency. These data will inform the site selection process during Meso-ORIGINS set-up.ReferenceFerguson K, Mercer R, King J, et al. S43 Preliminary results of the Meso-ORIGINS feasibility study: retrospective element regarding BAPE-mesothelioma evolution rate. Thorax 2021;76:A28.