The following is the summary of “Multimodality Therapy in Patients With Primary Pericardial Mesothelioma” published in the December 2022 issue of Thoracic oncology by Offin, et al.

The management and prognosis of patients with primary pericardial mesothelioma (PPM) are generally extrapolated from those with diffuse pleural mesothelioma because there are no established standard-of-care therapy options. To define PPM more precisely, disease-specific studies are required. Their institution’s history with PPM is described, along with the possible significance of multimodal treatment. Medical oncologists, thoracic surgeons, thoracic pathologists, and radiologists who made a PPM diagnosis between January 2011 and January 2022 monitored their patients until February 2022. Annotations on clinicopathologic characteristics and treatment results were included. 

The date of the pathologist’s diagnosis was used as the starting point for calculating overall survival (OS). There were 12 patients diagnosed with PPM, and their median age at diagnosis was 51 (range 21-71). About 75% of the samples were epithelioid (n=9), 25% were non epithelioid, and the majority of patients were female (n=8; 67%) (two sarcomatoid and one biphasic). Immunohistochemistry revealed the expression of at least two mesothelial markers in 92% of instances, 11 of 12. In this group, 25.9 months was the median survival time. A total of 5 patients with an OS of more than 12 months underwent pericardial radiotherapy. 

The overall survival (OS) for patients who got trimodality therapy (surgical resection, adjuvant chemotherapy, and radiation) was 70.3 months, compared to 8.2 months for patients who did not get radiation as part of a trimodality approach. PPM is a unique condition for which there is now no recognized treatment. Based on our results, trimodality therapy may be beneficial for certain patients with PPM.