Urso L, Silic-Benussi M, Boscolo A, et al. - Researchers prospectively investigated not only the prognostic role of circulating monocyte and cytokine levels but also their dynamic alteration during chemotherapy in malignant pleural mesothelioma (MPM) patients. This study included 31 MPM patients undergoing a first line therapy based on a platinum compound plus pemetrexed. At the baseline and at the end of induction chemotherapy, blood samples were obtained from patients. Patients with lower and higher monocytes count were found to have a median overall survival (OS) of 12.13 months vs 9.6 months, respectively. Applying a combined score, based on the connection of interleukin-10 (IL-10), TGF-β levels and monocytes count, patients were further stratified. Univariate and multivariate analysis revealed shorter OS and progression-free survival in relation to a high combined score. An elevation in monocytes and IL-10 levels, but not in TGF-β levels, was brought about by chemotherapy. Corroborating the prognostic worth of circulating levels of multiple immunosuppressive cytokines and inflammatory cells, using a wider validation set of MPM patients, was eventually recommended.