Biomarkers and prognostic factors for malignant pleural mesothelioma

Our plain-English summary of Biomarkers and prognostic factors for malignant pleural mesothelioma, by P. Vigneri, F. Martorana, L. Manzella, et al (Future Oncology, 2015).

The study

• Authors: P. Vigneri, F. Martorana, L. Manzella, S. Stella
• Journal: Future Oncology
• Published: 2015;11(24 Suppl):29-33
• Type of article: Review
• Cited by: 23 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

The increasing incidence and the dismal prognosis of malignant pleural mesothelioma calls for the identification of biomarkers that will allow a timely diagnosis; display prognostic value; and, predict the response to pharmacological agents employed for the treatment of the disease. Biomarkers associated with early diagnosis currently include mesothelin in combination with miRNA miR-103a-3p. As for prognostic biomarkers, the Cancer and Leukemia Group B (CALGB) and the European Organization for Research and Treatment of Cancer (EORTC) scores take into account different hematological and clinical parameters that distinguish patients with good prognosis from those with inferior outcomes. Fluorodeoxyglucose-PET, microarray expression data, neutrophil-to-lymphocyte ratios, c-MET expression, Ki-67 ratios and fibulin-3 levels have also been associated with disease outcome. Finally, thymidylate synthase protein cutoffs may predict mesothelioma response to the association of pemetrexed with a platinum derivative.

In plain English

This article was a short review, not a new study. The authors summarized recent published studies on biomarkers (measurable signs in blood, tissue, fluid or scans) that might help diagnose malignant pleural mesothelioma, show how patients are likely to fare, or predict response to treatment. Among the studies described, Weber and colleagues reported that combining mesothelin with the microRNA miR-103a-3p identified new cases with 95% sensitivity and 81% specificity. Scoring systems from the EORTC and CALGB groups used blood counts and clinical features to separate patients with better and worse outcomes. Ghanim and colleagues found, in 187 cases, that a high Ki-67 index went with shorter survival in epithelioid mesothelioma (7.5 vs 19.1 months) but was not an independent prognostic factor in non-epithelioid disease. Creaney and colleagues linked high fibulin-3 in pleural fluid to shorter survival. Zucali and colleagues linked low thymidylate synthase protein to disease control after carboplatin and pemetrexed. The authors concluded that no such biomarker was yet in common use, but that several might be introduced into practice in the near future. The article did not discuss asbestos exposure.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: narrative review of published studies on biomarkers for malignant pleural mesothelioma
• Who was studied: no population of its own; the review drew on published studies of patients with malignant pleural mesothelioma, with study sizes listed in a table
• Main results:
  • Weber et al. (cited study): mesothelin had 85% specificity and 74% sensitivity, and miR-103a-3p had 89% sensitivity and 63% specificity. Used together, the two markers identified new mesothelioma cases with 95% sensitivity and 81% specificity.
  • EORTC index (cited study, validated in 523 patients from ten trials): performance status above 0, stage IV disease, and mixed or sarcomatous histologies were associated with an inferior outcome.
  • CALGB index (cited study by Herndon and colleagues): of six patient subgroups, the one with the most favorable characteristics had a median survival of 13.9 months.
  • Levallet et al. (cited study, 157 cases): immunohistochemistry detected c-MET expression in 71.9% of cases, and strong c-MET membrane expression was associated with longer overall survival.
  • Ghanim et al. (cited study, 187 cases): in epithelioid mesothelioma, Ki-67 staining above the median (above 15%) was linked to shorter overall survival than low Ki-67 (7.5 vs 19.1 months, p less than 0.001). Ki-67 was not an independent prognostic factor in non-epithelioid mesothelioma.
  • Creaney et al. (cited study, 153 pleural effusion samples): high fibulin-3 levels in pleural fluid were independently associated with shorter survival (HR 2.05, p = 0.005).
  • Zucali et al. (cited study, 126 tumor specimens from a cohort including 99 patients treated with carboplatin and pemetrexed): low thymidylate synthase protein correlated with disease control (p = 0.027). Patients also had longer progression-free survival (p = 0.017) and overall survival (p = 0.022) when grouped by median histological score.
• The authors' conclusion: The authors concluded that no diagnostic, prognostic or predictive biomarker had yet come into common use for malignant pleural mesothelioma. They wrote that candidates such as mesothelin, miR-103a-3p, Ki-67, NLR, fibulin-3 and thymidylate synthase expression may be introduced in clinical practice in the near future, and that independent validation would require concerted multidisciplinary efforts.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Lung cancer, Mesothelioma.

Medical terms in this study, explained in our Lexicon: Biomarker, Pleural Mesothelioma, Prognosis, Mesothelin, Ki-67, Fibulin-3, Mesothelioma, Pemetrexed (Alimta).

Related studies

• Proteome screening of pleural effusions identifies galectin 1 as a diagnostic biomarker and highlights several prognostic biomarkers for malignant mesothelioma — F. Mundt, H.J. Johansson, et al. (2014)
• A proteomics-based approach identifies secreted protein acidic and rich in cysteine as a prognostic biomarker in malignant pleural mesothelioma — S.C. Kao, M.B. Kirschner, et al. (2016)
• Immune response profiling of malignant pleural mesothelioma for diagnostic and prognostic biomarkers — J. Creaney, I.M. Dick, et al. (2016)
• Prognostic value of several biomarkers for the patients with malignant pleural mesothelioma — H. Liu, L. Wu, et al. (2015)
• Urinary Metabolite Diagnostic and Prognostic Liquid Biopsy Biomarkers of Lung Cancer in Nonsmokers and Tobacco Smokers — B. Dalal, T. Tada, et al. (2024)
• Survival and prognostic factors in malignant pleural mesothelioma: a retrospective study of 314 patients in the west part of Japan — S. Nojiri, K. Gemba, et al. (2011)

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