Pleural sarcomatoid mesothelioma: clinical-pathological and survival analysis of a series of 80 cases, multicentre retrospective study

Introduction: Malignant pleural mesothelioma is a rare disease, but with a non-negligible incidence in asbestos-polluted areas. The sarcomatoid histotype (SMPM) is characterised by a particularly poor prognosis. Methodology: The characteristics and clinical outcomes of 80 patients with PMMS followed at the hospitals of Alessandria, Casale Monferrato, Rozzano and Padua were analysed. Results: After first-line chemotherapy partial response (PR) was observed in 2 patients (2.5%), disease stability (SD) in 32 patients (40%), disease progression (PD) in 25 patients (31%), non-assessable disease for 21 patients (26%). Time to progression (TTP) was 3.5 months; overall survival (OS) was 7.8 months. OS of patients receiving pemetrexed was 7.5 months vs 8.9 months of patients receiving chemotherapy without pemetrexed (p>0.05). Conclusion: The data confirm that sarcomatoid histotype has a worse prognosis than epithelioid, with poorer survival and poorer response to treatment. In particular, standard chemotherapy did not show efficacy, underlining the need for other therapeutic perspectives in clinical trials focusing on new biomolecular targets.