Malignant pleural mesothelioma is a rare but highly aggressive type of cancer. Because it spreads so quickly, treatment success can hinge on predicting which treatments are likely to work and choosing the right treatment protocol early. Now, there may be a new way to improve survival by making that prediction even more accurate.
Mesothelioma researchers at several medical centers across Austria say a cell protein, know as serum C-Reactive Protein (CRP), may hold the key. CRP is a type of protein produced in the liver when the body is experiencing acute inflammation or infection. CRP levels rise to help the body jump start its immune response.
To test the relationship between CRP levels and mesothelioma, researchers analyzed the medical records of 115 patients with a confirmed diagnosis of mesothelioma. Patients with any evidence of infectious disease were excluded from the study. Then they compared each patient’s pretreatment level of CRP with his or her response to a multimodality treatment approach, with or without surgery.
The researchers confirmed the value of CRP as an independent prognostic factor in mesothelioma. Patients who had an elevated CRP level before treatment had a significantly shorter overall survival than those with normal CRP levels.
But what the researchers found even more interesting was the relationship between CRP level and treatment type: “Among patients with normal CRP levels, radical tumor resection within multimodality therapy was associated with distinctly prolonged overall survival when compared with treatment protocols without surgery.” (From the study abstract in Annals of Surgery) In contrast, patients who started out with elevated CRP levels gained no survival advantage from multimodality approaches that included radical surgery.
What it Means
One of the most difficult decisions mesothelioma patients and their doctors have to make is what treatment, or combination of treatments, to use. Because radical mesothelioma surgery is traumatic and risky, even mesothelioma experts disagree about when it should be used. The new study gives mesothelioma patients and doctors another tool to help make them make the best treatments decisions possible.