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WCLC 2025 | The significance of BAP1 phenotyping for treating mesothelioma
Michele Carbone, MD, PhD, University of Hawaii Cancer Center, Honolulu, HI, highlights the significance of identifying BAP1 mutations in patients with a high risk of cancer and mesothelioma, as it can lead to a better understanding of why individuals with these mutations have better outcomes. Germline BAP1 mutation screening for patients will be crucial, as it can alter treatment approaches and potentially improve survival rates. This knowledge can also inform clinical trials, where the inclusion of BAP1 mutation carriers can provide valuable insights into the efficacy of new treatments. This interview took place at 2025 World Conference on Lung Cancer (WCLC) in Barcelona, Spain.
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Transcript
It’s critical for many reasons. First of all, I’ve been working with these families now, I discovered this condition for many years and if you are part of a family in which everybody gets cancer and develops mesothelioma, you grow up thinking that the moment that you cough, you’ve got cancer and you’re done. So the fact that we show that in fact they have less aggressive tumors, actually, if you want, when you have a BAP1 mutation, you have this paradox: on one hand, it’s bad because you are going to have cancer...
It’s critical for many reasons. First of all, I’ve been working with these families now, I discovered this condition for many years and if you are part of a family in which everybody gets cancer and develops mesothelioma, you grow up thinking that the moment that you cough, you’ve got cancer and you’re done. So the fact that we show that in fact they have less aggressive tumors, actually, if you want, when you have a BAP1 mutation, you have this paradox: on one hand, it’s bad because you are going to have cancer. On the other hand, if you have cancer, you wish you had a BAP1 mutation because people with a BAP1 mutation usually survive cancer. So right now we are studying why it is that people with a BAP1 mutation can fight cancer and the rest of the population cannot. In terms of other people, so that is important for the rest of the world because if we figure it out, we can help everybody, I hope. For the whole field of mesothelioma, it’s also important when you talk about clinical trials because all you need is a few of these patients in an arm of the clinical trial and you think that your medicine has worked great, or has not worked; this was in the control group. So it’s very important that everybody is checked for germline BAP1 mutations first of all because if they carry them, they need a different approach to therapy and they can live longer, forever, many of them. And the other one is that if you put them in a clinical trial, then you think that you found the medicine that works great, and it just happened that you had a family who was affected by BAP1 who was coming to your hospital, you have four or five of them in your clinical trial, and now suddenly they are all responding to therapy.
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