New research confirms that some mesothelioma biomarkers are much more effective than others for detecting asbestos cancer.
The news comes from a study conducted at the Icahn School of Medicine at Mount Sinai in New York. Researchers ran an analysis of more than 50 studies on three popular mesothelioma biomarkers.
They concluded that two of them make good mesothelioma screening tools but one of them does not.
The Challenge of Early Mesothelioma Diagnosis
Mesothelioma is a highly aggressive cancer caused by exposure to asbestos. As with most cancers, the odds of surviving mesothelioma are higher if it is caught early. But mesothelioma does not cause many symptoms in the early stages. This can make it challenging to diagnose.
Even before mesothelioma symptoms like coughing and chest pain develop, there may be subtle signs of cancer.
One of the signs is elevated levels of key proteins in the blood and lung fluid. These proteins can function as mesothelioma biomarkers.
Some Mesothelioma Biomarkers are Better Than Others
The Mount Sinai researchers performed a meta-analysis on three of the top mesothelioma biomarkers. A meta-analysis is a study of studies. The team searched the medical literature for studies on mesothelin, fibulin-3, and osteopontin in blood or lung fluid.
They found 32 studies on mesothelin levels, 12 studies on osteopontin levels, and 9 studies on fibulin-3 levels. The analysis compared the levels of these three proteins in the blood and lung fluid of four groups of people:
- healthy people
- people with non-cancer lung conditions
- people with mesothelioma
- people with other kinds of cancer
Best Performing Mesothelioma BIomarkers
Among the mesothelioma biomarkers studied, the one with the most evidence behind it was mesothelin. “Statistically significant mean differences were seen between [pleural mesothelioma] patients and all other comparison groups for mesothelin blood and pleural levels,” writes study author Christina Gillezeau, MPH.
There were also big differences in fibulin-3 levels between mesothelioma patients and all of the other groups.
Osteopontin turned out to be the only one of the three mesothelioma biomarkers that was not very different between people with mesothelioma and those with other cancers.
“Osteopontin may be a useful biomarker for screening healthy individuals or those with benign lung disease, but would not be useful for screening patients with malignancies,” writes Gillezeau. On the other hand, the report concludes that both mesothelin and fibulin-3 are “good candidates for screening biomarkers.”
About 3,000 people receive a mesothelioma diagnosis in the US each year. Most of them have no idea they have it until it is in an advanced stage.
In addition to looking for biomarkers, diagnosis also typically involves imaging studies and examination of suspected tumor cells. A thorough work history – including any history of asbestos exposure – is also vital.
Gillezeau, C, et al, “Biomarkers for malignant pleural mesothelioma: a meta-analysis”, June 5, 2019, Concrinogenesis, Epub ahead of print, https://academic.oup.com/carcin/advance-article-abstract/doi/10.1093/carcin/bgz103/5512004?redirectedFrom=fulltext