Malignant mesothelioma patients may not need multiple CT scans to tell whether their cancer has progressed in the months after chemotherapy treatment.
UK researchers say a simple blood test to check their levels of the protein mesothelin costs less, requires fewer hospital visits, and is 96 percent accurate in most mesothelioma patients.
Measuring Mesothelioma Progression
The study was conducted by scientists at the University of Bristol who recruited 41 patients with malignant pleural mesothelioma to participate for at least a year after the end of their treatment.
The mesothelioma patients included in the study had received either chemotherapy or best supportive care. At the end of chemotherapy (or from baseline in the patients receiving best supportive care), patients had a monthly blood test to measure their mesothelin levels.
These blood tests were paired with six monthly CT scans. Doctors then correlated patients’ changes in mesothelin levels with evidence of mesothelioma progression on the CT scans and with overall mesothelioma survival.
Mesothelin Predicts Mesothelioma Survival
Across the board, researchers found that a 10 percent rise in serum mesothelin levels confirmed mesothelioma progression (as evidenced on the CT scan) with 96 percent accuracy for people with the most common type of mesothelioma (epithelioid). For those with the less common sarcomatoid mesothelioma, accuracy was a little less at 80 percent.
The mesothelin blood test was 74 percent accurate at identifying patients whose pleural mesothelioma had not progressed.
When it came to mesothelioma survival, the researchers found that patients whose mesothelin levels stayed steady or fell at the six month mark, lived an average of two-and-a-half times longer than those with rising mesothelin levels at six months.
What It Means for Mesothelioma Patients
Although other studies have found mesothelin to be a valuable marker for mesothelioma progression during treatment, the new study is the first to assess its value in detecting pleural mesothelioma progression after chemotherapy or best supportive care.
Writing in the journal BMC Cancer, lead study author Duneesha de Fonseka said the findings have some potentially positive implications for people going through mesothelioma treatment and their families.
“A 10% rise in serum mesothelin level showed excellent sensitivity at predicting progressive disease,” writes Dr. de Fonseka. “Mesothelin measurement has several advantages over serial CT imaging including reducing hospital visits and cost.”
De Fonseka, D, et al, “A prospective study to investigate the role of serial serum mesothelin in monitoring mesothelioma”, February 17, 2018, BMC Cancer