A recent review article written by scientists in Italy discusses the current state-of-the-art research on pleural mesothelioma. The work, titled “Biomarkers and prognostic factors for malignant pleural mesothelioma“ appeared November, 2015, in the journal Future Medicine.
Pleural mesothelioma is a rare and aggressive cancer. Mesothelioma refers to a tumor of the lung lining, and can affect other organs including the stomach and heart. It can lead to thickening of the lung tissue and cause trouble breathing. Pleural mesothelioma is the most common of four types, accounting for 75% of all mesotheliomas. The main cause of pleural mesothelioma cancer is asbestos exposure. The one-year survival rate is 38 percent. This is likely because few people see a doctor who is a specialist in treating the disease. The early detection and treatment is pleural mesothelioma is crucial.
Currently, the identification of pleural mesothelioma is not optimal. Many physicians do not know what clear clinical signs to look for and are not prepared to diagnose the disease. Biomarkers for pleural mesothelioma could aid in the diagnosis of the disease, in predicting the aggressiveness of the cancer and in identifying targets for potential treatment.
The researchers, led by Paolo Vigneri of the Department of Clinical & Experimental Medicine, University of Catania, Catania, Italy, discussed current biomarkers that may aid in pleural mesothelioma diagnosis and prognosis. These include: mesothelin in combination with the micro RNA, miRNA miR-103a-3p. The biomarker could be measured along with the use of the Cancer and Leukemia Group B (CALGB) and the European Organization for Research and Treatment of Cancer (EORTC) scores, standardized tools for assessing cancer. Use of these measurements may help to distinguish patients with good prognosis from those with poor clinical prognosis.
Additional biomarkers may include: fluorodeoxyglucose-PET, microarray expression data, neutrophil-to-lymphocyte ratios, c-MET expression, Ki-67 ratios and fibulin-3 levels. Various research groups have determined that all of the biomarkers can potentially predict disease outcome. In addition, thymidylate synthase protein cutoffs could be used to predict how the cancer will respond to a specific treatment, known as pemetrexed with a platinum derivative. This medication is effective for lung cancer.
Overall, the identification and treatment of pleural mesothelioma warrants improvement. Identification of specific biomarkers can advance the identification of the disease, aid in treatment choices and potentially help in the identification of new treatments for this type of cancer. Ultimately, however, clinicians need to be aware of the signs and symptoms of pleural mesothelioma and need to be prepared to question their patients about potential asbestos exposure.