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Lookup NU author(s): Dr Andrew Stanton
This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).
© Author(s) (or their employer(s)) 2026. Re-use permitted under CC BY. Published by BMJ Group. This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.Introduction: 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: ISRCTN22929761.
Author(s): Neilly MDJ, MacPherson A, Alexander L, Walker N, Kelly C, Roche J, Abugassa E, Allan L, Ashraf A, Aujayeb A, Bibby A, Bilancia R, Corcoran J, Chetty M, Conroy K, Craig C, Crook R, D'Souza A, Daneshvar C, DeFoneska D, Denniston P, Fallon J, Ferguson K, Gatheral T, Griffiths AL, Haris M, Hashim M, Ionescu A, Kadwani O, Macdougall M, Maclay JD, Mann ON, Maskell N, Morrison M, Panchal R, Prudon B, Rahman NM, Sudhir R, Ramsaroop S, Reddy R, Reid P, Sage E, Short P, Stanton AE, Succony L, Tsaknis G, Tsim S, Cowell G, Lamote K, Blyth KG
Publication type: Article
Publication status: Published
Journal: BMJ Open Respiratory Research
Year: 2026
Volume: 13
Issue: 1
Online publication date: 01/07/2026
Acceptance date: 15/03/2026
Date deposited: 17/07/2026
ISSN (electronic): 2052-4439
Publisher: BMJ Publishing Group
URL: https://doi.org/10.1136/bmjresp-2025-004045
DOI: 10.1136/bmjresp-2025-004045
Data Access Statement: Data are available upon reasonable request. The datasets generated during and/or analysed during the current study are/will be available upon request from the PREDICT- Meso Research Tissue Bank (REC approval 21/WS/011). Please contact alexandrea. macpherson@ glasgow. ac. uk for details on the data available and application process. Patient consent will be obtained that allows storage in the Research Tissue Bank and appropriate sharing of samples and data with the mesothelioma research community. A copy of the PREDICT- Meso Research Tissue Bank Governance, Collection and Access policy can be made available upon request. This covers access criteria; what data will be shared including with whom, for what types of analyses, and by what mechanism, comments on data anonymisation, any ethical or legal restrictions.
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