Evidence map›Paper›PMID 42045690›Full record

ArticleNature genetics2026

Tumor DNA methylation subtypes predict immunotherapy outcomes in pleural mesothelioma patients in the NIBIT-EPI-MESO study.

Luana Calabrò, Francesca P Caruso, Alessia Covre, Teresa M R Noviello, Maria F Lofiego, Rossella Tufano, Luigi Ferraro, Piera Grisolia, Antonio De Falco, Vincenzo Lagano and 21 more

Abstract readMulticenter Study
PubMed Publisher
In one paragraph

Article in Nature genetics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

31 authors.

Luana Calabrò *Department of Translational Medicine, University of Ferrara, Ferrara, Italy.
Francesca P Caruso *Biogem Institute of Molecular Biology and Genetics, Ariano Irpino, Italy.
Alessia Covre *University of Siena, Italy, and Center for Immuno-Oncology, Department of Oncology, University Hospital of Siena, Siena, Italy.
Teresa M R NovielloSylvester Comprehensive Cancer Center and Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami, FL, USA.ORCID http://orcid.org/0000-0002-3411-6752
Maria F LofiegoUniversity of Siena, Italy, and Center for Immuno-Oncology, Department of Oncology, University Hospital of Siena, Siena, Italy.
Rossella TufanoBiogem Institute of Molecular Biology and Genetics, Ariano Irpino, Italy.ORCID http://orcid.org/0000-0002-9158-3533
Luigi FerraroSylvester Comprehensive Cancer Center and Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami, FL, USA.
Piera GrisoliaSylvester Comprehensive Cancer Center and Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami, FL, USA.
Antonio De FalcoBiogem Institute of Molecular Biology and Genetics, Ariano Irpino, Italy.ORCID http://orcid.org/0000-0003-2396-3101
Vincenzo LaganoDepartment of Experimental Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.ORCID http://orcid.org/0000-0002-5965-0361
Francesco SgambelluriDepartment of Experimental Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
Giovanna SabellaPathology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
Giulia RossiUniversity of Siena, Italy, and Center for Immuno-Oncology, Department of Oncology, University Hospital of Siena, Siena, Italy.
Giulia GibiliscoUniversity of Siena, Italy, and Center for Immuno-Oncology, Department of Oncology, University Hospital of Siena, Siena, Italy.
Francesco MarzaniUniversity of Siena, Italy, and Center for Immuno-Oncology, Department of Oncology, University Hospital of Siena, Siena, Italy.ORCID http://orcid.org/0009-0005-9399-4511
Emma BelloUniversity of Siena, Italy, and Center for Immuno-Oncology, Department of Oncology, University Hospital of Siena, Siena, Italy.
Elena SimonettiUniversity of Siena, Italy, and Center for Immuno-Oncology, Department of Oncology, University Hospital of Siena, Siena, Italy.
Vincenzo D'AlonzoUniversity of Siena, Italy, and Center for Immuno-Oncology, Department of Oncology, University Hospital of Siena, Siena, Italy.ORCID http://orcid.org/0000-0002-9264-377X
Michele CaragliaBiogem Institute of Molecular Biology and Genetics, Ariano Irpino, Italy.
Sandra CoralUniversity of Siena, Italy, and Center for Immuno-Oncology, Department of Oncology, University Hospital of Siena, Siena, Italy.
Antonina De AngelisMesothelioma, Melanoma and Rare Cancers Unit, Azienda Ospedaliera Universitaria, Alessandria, Italy.
Luigi CerboneMesothelioma, Melanoma and Rare Cancers Unit, Azienda Ospedaliera Universitaria, Alessandria, Italy.
Sara DelfantiMesothelioma, Melanoma and Rare Cancers Unit, Azienda Ospedaliera Universitaria, Alessandria, Italy.ORCID http://orcid.org/0000-0002-9862-7340
Diana GiannarelliFondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
Federica GrossoMesothelioma, Melanoma and Rare Cancers Unit, Azienda Ospedaliera Universitaria, Alessandria, Italy.
Anna Maria Di GiacomoUniversity of Siena, Italy, and Center for Immuno-Oncology, Department of Oncology, University Hospital of Siena, Siena, Italy.
Massimo MilionePathology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
Roberta MortariniDepartment of Experimental Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
Andrea AnichiniDepartment of Experimental Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
Michele CeccarelliSylvester Comprehensive Cancer Center and Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami, FL, USA. mxc2982@miami.edu.ORCID http://orcid.org/0000-0002-4702-6617
Michele MaioUniversity of Siena, Italy, and Center for Immuno-Oncology, Department of Oncology, University Hospital of Siena, Siena, Italy. maio@unisi.it.

Funding

Associazione Italiana per la Ricerca sul Cancro (Italian Association for Cancer Research) ID.21073Ministero della Salute (Ministry of Health, Italy) NET-2016-02361632Regione Lombardia (Region of Lombardy) NET-2016-02361632Regione Toscana (Tuscany Region) NET-2016-02361632
6 · The paper itself

Abstract

Pleural mesothelioma (PM) has a poor prognosis and standard therapy with immune checkpoint inhibitors (ICIs) CTLA-4 and PD-1 is still clinically unsatisfying. No predictive biomarkers of ICI efficacy in PM are available yet. In the retrospective multicenter NIBIT-EPI-MESO study, multi-omics analysis of pre-ICI therapy tumor lesions from 91 patients with PM treated in earlier clinical trials or in daily practice identified four PM subsets with progressively increasing global DNA methylation profiles-demethylated, LOW, intermediate and CpG island methylator phenotype (CIMP). These methylation subsets predicted response and survival to ICI therapy. The LOW subset was enriched in responder patients, who had the longest median overall survival and the highest 3-year overall survival rate, and showed a T cell- and B cell-rich immune microenvironment. Conversely, the CIMP subtype was enriched in nonresponder patients with the shortest median overall survival and overall survival, along with a depleted immune microenvironment. A methylation-based probabilistic decision-making classification tool to predict the outcome of ICI treatment in patients with PM was developed.

Indexed as

DNA MethylationImmunotherapyMesotheliomaPleural NeoplasmsAgedBiomarkers, TumorCpG IslandsFemaleHumansImmune Checkpoint InhibitorsMaleMesothelioma, MalignantMiddle AgedPrognosisRetrospective StudiesTreatment OutcomeBiomarkers, TumorImmune Checkpoint Inhibitors

Identifiers

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.