Italian researchers say it’s possible to monitor mesothelioma tumor progression with a simple blood test.
They make their case in a Letter to the Editor in the latest edition of the Journal of Thoracic Oncology.
The researchers say blood serum levels of the protein mesothelin correlate closely with tumor volume in malignant pleural mesothelioma patients. They are recommending that the blood test be used alongside CT to track mesothelioma tumor progression.
The Importance of Monitoring Mesothelioma Tumor Progression
Pleural mesothelioma is a rare cancer with a grim prognosis. Mesothelioma tumors tend to grow and spread quickly. Doctors have to carefully monitor mesothelioma tumor progression to tell if a treatment is working.
Most mesothelioma patients have chemotherapy with Alimta (pemetrexed) and cisplatin. If the cancer comes back, they may have a second round of chemotherapy, radiation, or an investigational treatment.
If a mesothelioma treatment is not having an impact on tumor growth, doctors need to know as soon as possible. This allows them to quickly course-correct and try something else.
A Simpler Way to Track Pleural Thickness
One of the main ways to monitor mesothelioma tumor progression is by measuring the thickness of the pleura. The pleura is a membrane around the lungs where mesothelioma tumors form. Monitoring is typically done with computed tomography (CT).
But CT scanning is time consuming. The equipment and the expertise required make it expensive. And there are situations where CT is not feasible or even available.
In these cases, the Italian researchers say blood testing for mesothelin is an effective alternative for tracking mesothelioma tumor progression.
“Although CT provides direct information by images on the variety of malignant pleural mesothelioma tumor volume and onset of new metastases, it cannot always be performed,” states the Letter to the Editor. “In contrast, testing Se-SMRP [mesothelin] provides faster information and it can be performed together with other routine blood tests at each patient’s visit.”
The study included 10 malignant pleural mesothelioma patients who received chemotherapy.
After adjusting for age and disease stage, the researchers found that mesothelin levels increased as pleural thickness increased, which correlated with mesothelioma tumor progression.
“This study confirms our previous finding of a strong positive association between [mesothelin] and CT,” write the researchers.
Doctors use a test called MESOMARK to measure serum mesothelin. MESOMARK is often combined with other tests and imaging studies to help diagnose mesothelioma.
Fontana, V, et al, “The Correlation of Serum Mesothelin Level With Pleural Thickness in Malignant Pleural Mesothelioma Makes it a Valuable Tool for Monitoring Tumor Progression”, May 2019, Journal of Thoracic Oncology, https://www.jto.org/article/S1556-0864(19)30016-4/fulltext