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Dissecting heterogeneity in malignant pleural mesothelioma through histo-molecular gradients for clinical applications
Dissecting heterogeneity in malignant pleural mesothelioma through histo-molecular gradients for clinical applications
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Dissecting heterogeneity in malignant pleural mesothelioma through histo-molecular gradients for clinical applications
Dissecting heterogeneity in malignant pleural mesothelioma through histo-molecular gradients for clinical applications

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Dissecting heterogeneity in malignant pleural mesothelioma through histo-molecular gradients for clinical applications
Dissecting heterogeneity in malignant pleural mesothelioma through histo-molecular gradients for clinical applications
Journal Article

Dissecting heterogeneity in malignant pleural mesothelioma through histo-molecular gradients for clinical applications

2019
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Overview
Malignant pleural mesothelioma (MPM) is recognized as heterogeneous based both on histology and molecular profiling. Histology addresses inter-tumor and intra-tumor heterogeneity in MPM and describes three major types: epithelioid, sarcomatoid and biphasic, a combination of the former two types. Molecular profiling studies have not addressed intra-tumor heterogeneity in MPM to date. Here, we use a deconvolution approach and show that molecular gradients shed new light on the intra-tumor heterogeneity of MPM, leading to a reconsideration of MPM molecular classifications. We show that each tumor can be decomposed as a combination of epithelioid-like and sarcomatoid-like components whose proportions are highly associated with the prognosis. Moreover, we show that this more subtle way of characterizing MPM heterogeneity provides a better understanding of the underlying oncogenic pathways and the related epigenetic regulation and immune and stromal contexts. We discuss the implications of these findings for guiding therapeutic strategies, particularly immunotherapies and targeted therapies. Malignant pleural mesothelioma (MPM) is a rare and aggressive form of cancer. Here, the authors show MPM is heterogeneously composed of epithelioid and sarcomatoid components and their proportions associate with prognosis and could inform therapeutic strategies.