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The Best Biomarkers for Mesothelioma Diagnosis, Prognosis, & Monitoring

Best Biomarkers for Mesothelioma

What are the best biomarkers for mesothelioma? The answer is still Soluble Mesothelin-Related Proteins (SMRPs).

That is the conclusion of a major review of medical literature by some of the world’s top mesothelioma experts. Dr. Harvey Pass of New York University’s Langone Medical Center and Dr. Michele Carbone of the University of Hawaii are among the authors on the new report. 

They analyzed 20 years of research on the best biomarkers for mesothelioma. Several were valuable for mesothelioma prognosis. But SMRPs once again came out the winner for mesothelioma prognosis, diagnosis, and treatment monitoring. 

How Do Biomarkers Work?

A biomarker is any substance produced by the body that can act as a biological signpost. Proteins usually make the best biomarkers for mesothelioma. The proteins may be in the tissue, blood, or other body fluid. Some biomarkers are even in the exhaled breath. 

Lung fluid is a common place to find mesothelioma markers. People with mesothelioma usually produce excess lung fluid called pleural effusions. Doctors can extract some of the fluid and test it. 

Lung fluid tests may be combined with other biomarker tests and imaging studies. Together, they offer a non-invasive way for doctors to gather clues about a patient’s illness.

What the Best Biomarkers for Mesothelioma Do

Doctors often use biomarkers to help diagnose mesothelioma. They can also use them to predict how an individual will respond to mesothelioma treatment. During treatment, biomarkers can show if the therapy is working. The best biomarkers for mesothelioma do all three. 

The National Cancer Institute funds research on biomarkers around the country. Different laboratories focus on finding and testing biomarkers for different types of cancer. Two of these Early Detection Research Network (EDRN) sites focus on mesothelioma. The EDRN Mesothelioma Biomarker Discovery Labs are located at NYU and the University of Hawaii.

Researchers from both institutions prepared the new report on the best biomarkers for mesothelioma. They analyzed studies on proposed mesothelioma biomarkers including SMRP, osteopontin, calretinin, fibulin 3, and High-Mobility Group Box 1 (HMGB1). 

They conclude that SMRPs in the blood make the best biomarkers for mesothelioma. 

According to the report, “Soluble Mesothelin-Related Proteins (SMRP) have been characterized extensively and constitute an FDA-approved biomarker in plasma with diagnostic, monitoring and prognostic value in MPM.”

The FDA-approved MESOMARK assay tests for SMRPs in the blood. 

Other Ways to Track Mesothelioma

SMRPs may be the best biomarkers for mesothelioma, but others may also help in its management. The group concluded that the protein osteopontin is helpful for mesothelioma prognosis. It is not as valuable for diagnosis as SMRPs. 

“Other biomarkers such as calretinin, fibulin 3, and High-Mobility Group Box 1 (HMGB1) remain under study and need international validation trials with large cohorts of cases and controls to demonstrate any utility.” the team concludes. 

Large cohorts are a challenge because mesothelioma is so rare. 

In the meantime, a positive MESOMARK test does not mean that a person has mesothelioma. Doctors use a combination of biomarkers, biopsies, imaging studies, physical exams and patient histories to diagnose mesothelioma and track its progression.


Pass, H, et al, “Mesothelioma Biomarkers: A Review Highlighting Contributions from the Early Detection Research Network”, July 22, 2020, Cancer Epidemiology, Biomarkers & Prevention, Epub ahead of print, https://cebp.aacrjournals.org/content/early/2020/07/22/1055-9965.EPI-20-0083

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