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Indolent peritoneal mesothelioma: PI3K-mTOR inhibitors as a novel therapeutic strategy

Peritoneal mesothelioma (MPeM) is a scarce abdominal-pelvic malignancy that presents with non-specific features and exhibits a wide clinical spectrum from indolent to aggressive disease. Due to it being a rare entity, there is a lack of understanding of its molecular drivers. Most treatment data are...

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Autores principales: Dolly, Saoirse O, Migali, Cristina, Tunariu, Nina, Della-Pepa, Chiara, Khakoo, Shelize, Hazell, Steve, de Bono, Johann S, Kaye, Stanley B, Banerjee, Susana
Formato: Online Artículo Texto
Lenguaje:English
Publicado: ESMO Open 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5519796/
https://www.ncbi.nlm.nih.gov/pubmed/28761723
http://dx.doi.org/10.1136/esmoopen-2016-000101
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author Dolly, Saoirse O
Migali, Cristina
Tunariu, Nina
Della-Pepa, Chiara
Khakoo, Shelize
Hazell, Steve
de Bono, Johann S
Kaye, Stanley B
Banerjee, Susana
author_facet Dolly, Saoirse O
Migali, Cristina
Tunariu, Nina
Della-Pepa, Chiara
Khakoo, Shelize
Hazell, Steve
de Bono, Johann S
Kaye, Stanley B
Banerjee, Susana
author_sort Dolly, Saoirse O
collection PubMed
description Peritoneal mesothelioma (MPeM) is a scarce abdominal-pelvic malignancy that presents with non-specific features and exhibits a wide clinical spectrum from indolent to aggressive disease. Due to it being a rare entity, there is a lack of understanding of its molecular drivers. Most treatment data are from limited small studies or extrapolated from pleural mesothelioma. Standard treatment includes curative surgery or pemetrexed-platinum palliative chemotherapy. To date, the use of novel targeted agents has been disappointing. Described is the management of two young women with papillary peritoneal mesothelioma with widespread recurrence having received platinum-pemetrexed chemotherapy. Both patients obtained symptomatic and disease benefit with apitolisib, a dual phosphoinositide 3-kinase-mammalian target of rapamycin (PI3K-mTOR) inhibitor for subsequent relapses, with one patient having a partial response for almost 3 years. Both are alive and well 10–13 years from diagnosis. CONCLUSION: These case presentations highlight a subgroup of rare MPeM that behave indolently that is compatible with long-term survival. This series identifies the use of targeted therapies with PI3K-mTOR-based inhibitors as a novel approach, warranting further clinical assessment. Development of prognostic biomarkers is essential to aid identify tumour aggressiveness, help stratify patients and facilitate treatment decisions.
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spelling pubmed-55197962017-07-31 Indolent peritoneal mesothelioma: PI3K-mTOR inhibitors as a novel therapeutic strategy Dolly, Saoirse O Migali, Cristina Tunariu, Nina Della-Pepa, Chiara Khakoo, Shelize Hazell, Steve de Bono, Johann S Kaye, Stanley B Banerjee, Susana ESMO Open Original Research Peritoneal mesothelioma (MPeM) is a scarce abdominal-pelvic malignancy that presents with non-specific features and exhibits a wide clinical spectrum from indolent to aggressive disease. Due to it being a rare entity, there is a lack of understanding of its molecular drivers. Most treatment data are from limited small studies or extrapolated from pleural mesothelioma. Standard treatment includes curative surgery or pemetrexed-platinum palliative chemotherapy. To date, the use of novel targeted agents has been disappointing. Described is the management of two young women with papillary peritoneal mesothelioma with widespread recurrence having received platinum-pemetrexed chemotherapy. Both patients obtained symptomatic and disease benefit with apitolisib, a dual phosphoinositide 3-kinase-mammalian target of rapamycin (PI3K-mTOR) inhibitor for subsequent relapses, with one patient having a partial response for almost 3 years. Both are alive and well 10–13 years from diagnosis. CONCLUSION: These case presentations highlight a subgroup of rare MPeM that behave indolently that is compatible with long-term survival. This series identifies the use of targeted therapies with PI3K-mTOR-based inhibitors as a novel approach, warranting further clinical assessment. Development of prognostic biomarkers is essential to aid identify tumour aggressiveness, help stratify patients and facilitate treatment decisions. ESMO Open 2017-04-12 /pmc/articles/PMC5519796/ /pubmed/28761723 http://dx.doi.org/10.1136/esmoopen-2016-000101 Text en © European Society for Medical Oncology (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted. This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
spellingShingle Original Research
Dolly, Saoirse O
Migali, Cristina
Tunariu, Nina
Della-Pepa, Chiara
Khakoo, Shelize
Hazell, Steve
de Bono, Johann S
Kaye, Stanley B
Banerjee, Susana
Indolent peritoneal mesothelioma: PI3K-mTOR inhibitors as a novel therapeutic strategy
title Indolent peritoneal mesothelioma: PI3K-mTOR inhibitors as a novel therapeutic strategy
title_full Indolent peritoneal mesothelioma: PI3K-mTOR inhibitors as a novel therapeutic strategy
title_fullStr Indolent peritoneal mesothelioma: PI3K-mTOR inhibitors as a novel therapeutic strategy
title_full_unstemmed Indolent peritoneal mesothelioma: PI3K-mTOR inhibitors as a novel therapeutic strategy
title_short Indolent peritoneal mesothelioma: PI3K-mTOR inhibitors as a novel therapeutic strategy
title_sort indolent peritoneal mesothelioma: pi3k-mtor inhibitors as a novel therapeutic strategy
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5519796/
https://www.ncbi.nlm.nih.gov/pubmed/28761723
http://dx.doi.org/10.1136/esmoopen-2016-000101
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