Protocol for Mesothelioma Observational study of Risk prediction and Generation of paired benign-meso tissue samples, Including a Nested MRI Substudy (Meso-ORIGINS)
Mark D J Neilly, Alexandrea MacPherson, Laura Alexander, Nicola Walker, Caroline Kelly, Joshua Roche, Emad Abugassa, Liam Allan, Adeel Ashraf, Avinash Aujayeb, Anna Bibby, Rocco Bilancia, John Corcoran, Mahendran Chetty, Kevin Conroy, Christopher Craig, Rebecca Crook, Alveena D’Souza, Cyrus Daneshvar, Duneesha DeFoneska, Poppy Denniston, Janet Fallon, Katie Ferguson, Timothy Gatheral, Andrew Lloyd Griffiths, Mohammed Haris, Mohammed Hashim, Alina Ionescu, Owais Kadwani, Michelle Macdougall, John D Maclay, Oliver Nesfield Mann, Nick Maskell, Morvern Morrison, Rakesh Panchal, Benjamin Prudon, Najib M Rahman, Rajini Sudhir, Sudarshan Ramsaroop, Raja Reddy, Phil Reid, Elizabeth Sage, Philip Short, Andrew E Stanton, Laura Succony, Georgios Tsaknis, Selina Tsim, Gordon Cowell, Kevin Lamote, Kevin G BlythIntroduction
Pleural mesothelioma (PM) is often presaged by benign asbestos-associated pleural inflammation (AAPI), offering a unique window of opportunity for translational research. The PREDICT-Meso International Accelerator Network is leveraging this natural history to perform target identification and develop novel therapies for early-stage or pre-invasive disease. This requires assembly of a unique bioresource of longitudinal human tissue samples spanning the terminal stages of PM evolution, development of preclinical models for drug screening and reliable tools for risk prediction in patients presenting with AAPI.
Methods and analysis
Mesothelioma Observational study of Risk prediction and Generation of paired benign-meso tissue samples, Including a Nested MRI Substudy (Meso-ORIGINS) is a prospective, multicentre observational study, comprising two arms (A and B), with a nested MRI substudy in arm A. Arm A will recruit 300 AAPI patients and perform 6-monthly surveillance for 2 years. Suspicion of PM evolution will prompt repeat biopsy and banking, delivering a primary objective of ≥38 longitudinal AAPI-PM tissue pairs. This target reflects a projected PM evolution rate of 14% (95% CI 10.5 to 19.2) derived from a prior multicentre feasibility trial. Multiomic risk profiling will be performed in arm A, using blood proteomics, exhaled breath metabolomics and perfusion MRI. Arm B will recruit 300 patients with suspected PM, permitting collection of multiregion pleural biopsies in patients spanning AAPI and PM timepoints for evaluation of anatomical heterogeneity. Where possible, patients in arm B diagnosed with AAPI will be recruited to arm A for 2-year surveillance +/− repeat biopsy in subsequent PM evolution cases. Pleural fluid will be collected in arm B for cell-line generation and diagnostic biomarker evaluation. Exhaled breath will be collected in arm B for diagnostic biomarker evaluation.
Ethics and dissemination
The study has ethical approval (REC Ref 21/WS/0120). Results will be disseminated via peer-reviewed journals and national/international scientific conferences. Tissues, data and derived omics will be shared via the PREDICT-Meso Research Tissue Bank (REC Ref 21/WS/0011).
Trial registration number