Preliminary Results of the Meso-ORIGINS Feasibility Study

Introduction: Malignant Pleural Mesothelioma (MPM) is presaged by BAPE (Benign Asbestos Pleural Effusion) in some patients. In a future study (Meso-ORIGINS) we will collect matched BAPE-MPM tissues in patients who develop MPM following BAPE and use this material in the PREDICT-Meso Accelerator programme, recently funded by CRUK. This will define the key biological events that drive/permit evolution of MPM, create new preclinical models and define new therapeutic targets. The feasibility study has recently concluded and full results will be available for ERS Congress. Methods: The primary objective was to determine recruitment feasibility, defined as ≥27 patients in 12 months from 4 centres. Baseline data were recorded in eligible patients (radiological/histological diagnosis of BAPE). The feasibility of repeat Local Anaesthetic Thoracoscopy (LAT), based on ultrasound, and the acceptability of this and other re-sampling methods were assessed after 6-months. The secondary objective was to refine the sample size estimate for Meso-ORIGINS. LAT databases at the study centres were retrospectively reviewed and the rate of subsequent MPM evolution was recorded in patients with BAPE. Results: 39 patients were recruited over 12 months (Glasgow 21, Manchester 12, Bristol 5, Oxford 1). Repeat LAT was feasible in 11/19 patients with complete data at the time of writing. 12/19 of these patients indicated they would consent to repeat LAT. Data collection is currently ongoing. Conclusions: Recruitment of sufficient numbers to Meso-ORIGINS would be feasible, if up-scaled as planned. The final results of this feasibility study will allow optimal design of this major component of the PREDICT-Meso Accelerator programme.