ArticleClinical Medicine Insights. Oncology2026
The Prognostic Significance of BRCA1-Associated Protein 1(BAP1) in Malignant Pleural Mesothelioma: A Systematic Review and Meta-Analysis.
Article in Clinical Medicine Insights. Oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Malignant pleural mesothelioma (MPM) originates from pleural mesothelial cells and represents a highly aggressive malignancy. Characterized by a prolonged latency period, poor survival prognosis, and non-specific clinical manifestations, MPM poses significant diagnostic and therapeutic challenges. BRCA-1-associated protein 1 (BAP1) is a nuclear deubiquitinating enzyme involved in chromatin regulation, homologous recombination, and programmed cell death. Although multiple studies have suggested that BAP1 loss or mutation holds prognostic significance in malignant pleural mesothelioma, this remains a matter of debate. Methods: A meta-analysis was conducted using data from the Web of Science, PubMed, Embase, Cochrane, and CNKI up to October 21, 2025. We included studies involving patients with malignant pleural mesothelioma that assessed the prognostic significance of BAP1. These studies reported hazard ratios (HR) and 95% confidence intervals (CI) for median overall survival (mOS) and median progression-free survival (mPFS). Results: A total of 14 articles meeting the inclusion criteria were identified, encompassing 1,835 patients. We conducted both univariate and multivariate analyses of mOS, revealing that BAP1 deletion or mutation consistently correlated with improved prognosis, with hazard ratios of 0.51 (95% CI, 0.45-0.58, P < 0.0001) and 0.62 (95% CI, 0.54-0.71, P < 0.0001), respectively. The values were statistically significant (P < 0.0001). Furthermore, analyses of mPFS continued to demonstrate that BAP1 deletion or mutation consistently correlated with improved prognosis (U: HR = 0.62, 95% CI = 0.39-0.99, P = 0.04; M: HR = 0.79, 95% CI = 0.51-1.24, P = 0.31), though this did not reach statistical significance. Sensitivity analyses confirmed the robustness of these findings, with minimal heterogeneity between studies. Conclusion: BAP1 serves as a potential prognostic marker for MPM, with its deletion or mutation indicating a favourable prognosis for patients. However, whether it provides valuable insights for various treatment strategies, including immunotherapy, requires further clinical investigation to determine.
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