Researchers have validated the accuracy of the International Association for the Study of Lung Cancer’s (IASLC) 2009 pleural mesothelioma database, with these findings presented by Wolf et al at the IASLC 2023 World Conference on Lung Cancer (Abstract MA17.04).
Background
Pleural mesothelioma often presents complex challenges for effective staging and prognostication. The IASLC’s 2009 database was designed to enhance the staging accuracy of mesothelioma cases. Subsequently, in 2014, an analysis of data from 1995 to 2009 led to the identification of supplemental prognostic factors.
Study Methods and Results
In this study, researchers evaluated the data of a validation cohort involving 1,733 patients who were entered into the pleural mesothelioma database between 2009 and 2019. To validate and enhance the pleural mesothelioma models using fresh clinical data, they then introduced additional variables for analysis. The researchers noted that two distinct models were evaluated—one incorporating clinicopathologic features and treatment (pathologic staging model) and the other encompassing parameters available at patient presentation (basic presentation model)—with model comparison based on Harrell’s C-index.
The training data set, comprising 3,101 patients, revealed a significant optimal cut point for mesothelin at 6.7 nmol/L using the running log-rank method. Univariate analysis highlighted anemia and elevated mesothelin levels as predictors of poorer survival.
Conclusions
“Our study highlights the significant strides made in pleural mesothelioma staging. By refining and validating prognostic models, we are advancing our ability to tailor treatment strategies and improve patient outcomes,” underscored lead study author Andrea Wolf, MD, of the Icahn School of Medicine at Mount Sinai. “Continued efforts to gather and analyze data will improve prognostication and individualized patient care,” she concluded.
