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. 2024 Aug 8:63:649-657.
doi: 10.2340/1651-226X.2024.34802.

Patient characteristics, treatment patterns, and survival outcomes for patients with malignant pleural mesothelioma in Denmark between 2011 and 2018: a nationwide population-based cohort study

Affiliations

Patient characteristics, treatment patterns, and survival outcomes for patients with malignant pleural mesothelioma in Denmark between 2011 and 2018: a nationwide population-based cohort study

Jens Benn Sørensen et al. Acta Oncol. .

Abstract

Background: Malignant pleural mesothelioma (MPM) is a rare thoracic malignancy with poor prognosis and limited treatment options. Immunotherapy shows potential for improved outcomes; however, real-world evidence on its use will take time to accumulate. This study examined patient characteristics, treatment patterns, overall survival (OS), and predictors of mortality among patients diagnosed with MPM in Denmark prior to the introduction of newer treatments.

Methods: This historical cohort study based on routinely collected Danish National Registry data included adults newly diagnosed with MPM between 01 January 2011 and 31 May 2018. Summary statistics were used to describe patient characteristics and initial treatment. OS was estimated using Kaplan-Meier methods; Cox regression was used to compare patient mortality against the (age/sex-matched) general population and to investigate mortality predictors.

Results: Overall, 880 patients were included; 44% had advanced MPM, 37% had non-advanced MPM, and 19% had unknown MPM stage. Median age at diagnosis was 71.9 years, and 82% of the patients were male. Within 180 days of diagnosis, no treatment was recorded for 215 patients (54%) with advanced MPM and 150 (46%) with non-advanced MPM. Median time-to-initial treatment (interquartile range) was 47 days (31-111) overall, 40 days (28-77) in patients with advanced MPM, and 53 days (35-121) with non-advanced MPM. Median OS was 13.7 months overall (non-advanced MPM: 18.0 months vs. advanced MPM: 10.0 months). Predictors of higher mortality were older age at diagnosis, histology, and advanced MPM stage.

Interpretation: These findings provide a baseline upon which to evaluate MPM epidemiology as newer treatments are adopted in routine practice.

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Conflict of interest statement

All authors have completed the ICMJE uniform disclosure form.

J.B.S. reports support for conference travel and advisory board participation from Bristol Myers Squibb. A.B.P., V.E., and S.K.S, are salaried employees of Aarhus University and/or Aarhus University Hospital. P.B. reports institutionally awarded research support and consultancy fees from Bristol Myers Squibb. R.C. and M.J.D. are employees of Bristol Myers Squibb, the study sponsor; M.J.D. also reports stock ownership in Bristol Myers Squibb. S.P.J. reports institutionally awarded research support and consultancy fees from Bristol Myers Squibb and Pfizer, and consultancy fees from Takeda. C.R. is an independent consultant paid by the study sponsor, Bristol Myers Squibb. M.J.S. is an employee of IQVIA, a contract research organization paid by the study sponsor, Bristol Myers Squibb.

Figures

Figure 1
Figure 1
Initial therapy combination for patients with MPM. MPM: malignant pleural mesothelioma; RT: radiotherapy; SACT: systematic anticancer therapy.
Figure 2
Figure 2
(A) Overall survival (overall patient population). (B) Overall survival by sex (overall patient population). (C) Overall survival by MPM stage. CI: confidence interval; MPM: malignant pleural mesothelioma; OS: overall survival; yr: year. Frequencies rounded to nearest 5.
Figure 3
Figure 3
Predictors for overall survival up to 8 years. Hazard ratios obtained from Cox regression model with time in study as underlying time variable, adjusting for all other factors shown in the figure. CCI: Charlson Comorbidity Index; HR: hazard ratio; MPM: malignant pleural mesothelioma; RT: radiotherapy; SACT: systematic anticancer therapy; TNM: tumour, node, metastasis. Frequencies rounded to nearest 5.

References

    1. Tedesco J, Jaradeh M, Vigneswaran WT. Malignant pleural mesothelioma: current understanding of the immune microenvironment and treatments of a rare disease. Cancers (Basel). 2022;14(18):4415. 10.3390/cancers14184415 - DOI - PMC - PubMed
    1. Zhai Z, Ruan J, Zheng Y, Xiang D, Li N, Hu Jet al. . Assessment of global trends in the diagnosis of mesothelioma from 1990 to 2017. JAMA Netw Open. 2021;4(8):e2120360. 10.1001/jamanetworkopen.2021.20360 - DOI - PMC - PubMed
    1. Baas P, Fennell D, Kerr KM, Van Schil PE, Haas RL, Peters Set al. . Malignant pleural mesothelioma: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2015;26 Suppl 5:v31–v39. 10.1093/annonc/mdv199 - DOI - PubMed
    1. Hemminki K, Forsti A, Chen T, Hemminki A. Incidence, mortality and survival in malignant pleural mesothelioma before and after asbestos in Denmark, Finland, Norway and Sweden. BMC Cancer. 2021;21(1):1189. 10.1186/s12885-021-08913-2 - DOI - PMC - PubMed
    1. Scherpereel A, Opitz I, Berghmans T, Psallidas I, Glatzer M, Rigau Det al. . ERS/ESTS/EACTS/ESTRO guidelines for the management of malignant pleural mesothelioma. Eur Respir J. 2020;55(6):1900953. 10.1183/13993003.00953-2019 - DOI - PubMed

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