Diagnosis and prognosis—review of biomarkers for mesothelioma

Abstract

Malignant pleural mesothelioma (MPM) is an aggressive disease arising in pleural cell lining and is associated with asbestos exposure. Today, there is a rising incidence of MPM reaching 3,000 annual cases nationally, primarily from the large population occupationally exposed to asbestos between 1940 and 1980. With a prolonged latency period, presenting clinically 10 to 40 years after exposure, MPM is often diagnosed in late stages and presents median survival time of less than 12 months. There is a serious need for improvement in prognostic and diagnostic tools for MPM. Recent investigation and discovery of various biomarkers has shown promise, including Osteopontin, Fibulin-3, Soluble Mesothelin-Related Proteins (SMRP), High Mobility Group Box 1 (HMGB1), micro-RNA's, peripheral blood-based markers, and Slow Off-rate Modified Aptamer (SOMAmer) proteomic assays. In this review, we explore these current major biomarkers and their prognostic and diagnostic potential, highlighting the most recent large studies and developments for each. While progress has been made in mesothelioma research, many questions remain unanswered. Increased international cooperation is necessary for improving validity of results for current biomarkers through repeated investigation and increasing cohort sizes, as well as for the continued search for new and better markers.

Asbestos-Related Diseases and Blood Biomarkers

“…On the other hand, some other studies suggested that plasma fibulin-3 levels have low diagnostic accuracy [48][49][50]. The study of Creaney et al identified soluble mesothelin as a superior diagnostic biomarker for MM compared to fibulin-3, whereas fibulin-3 provided superior prognostic information compared to mesothelin [48].…”

Patient selection for radical surgery for mesothelioma—prognostic factors in a multimodality approach

“…and Sun et al, groups from the University of Hawaii Cancer Center and NYU Langone Medical Center (50,51). The authors listed the most promising markers associated with diagnosis and prognosis of MPM in the current research field.…”

“…In summary, while all of these markers showed promising results, most have yet to be independently and prospectively validated, and for some of them controversial results from different studies concerning their prognostic impact need to be addressed (51). So far, all these above-mentioned markers and their potential prognostic value have no impact in patient selection, but may be included in selection algorithms alongside with clinical markers in prognostic scores.…”

Data mining analysis of the PP2A cell cycle axis in mesothelioma patients

“…Other possible regions affected by this disease are the peritoneum, the pericardium and the tunica of testis and ovary (Bridda, Padoan, Mencarelli, & Frego, 2007). Although rare, with around 3,000 new patients diagnosed each year alone in the United States (Sun, Vaynblat, & Pass, 2017), it is considered a very aggressive and deadly form of cancer (Carbone et al, 2019).…”