Biomolecular and clinical practice in malignant pleural mesothelioma and lung cancer: what thoracic surgeons should know

Our plain-English summary of Biomolecular and clinical practice in malignant pleural mesothelioma and lung cancer: what thoracic surgeons should know, by I. Opitz, R. Bueno, E. Lim, et al (European Journal of Cardio-thoracic Surgery, 2014).

The study

• Authors: I. Opitz, R. Bueno, E. Lim, H. Pass, U. Pastorino, M. Boeri, G. Rocco, C.L.U.B. ESTS Biology
• Journal: European Journal of Cardio-thoracic Surgery
• Published: 2014;46(4):602-6
• Type of article: Review
• Cited by: 2 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Today, molecular-profile-directed therapy is a guiding principle of modern thoracic oncology. The knowledge of new biomolecular technology applied to the diagnosis, prognosis, and treatment of lung cancer and mesothelioma should be part of the 21st century thoracic surgeons' professional competence. The European Society of Thoracic Surgeons (ESTS) Biology Club aims at providing a comprehensive insight into the basic biology of the diseases we are treating. During the 2013 ESTS Annual Meeting, different experts of the field presented the current knowledge about diagnostic and prognostic biomarkers in malignant pleural mesothelioma including new perspectives as well as the role and potential application of microRNA and genomic sequencing for lung cancer, which are summarized in the present article.

© The Author 2014. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

In plain English

This article was a review, not an original study. It summarized a session of the European Society of Thoracic Surgeons Biology Club at the 2013 annual meeting in Birmingham, UK, on blood and tissue markers in malignant pleural mesothelioma and lung cancer. For mesothelioma, it described research on blood tests to detect the disease in asbestos-exposed people. It reported that a protein called HMGB1 was raised in asbestos-exposed people but also in mesothelioma patients, so it could not single out mesothelioma. It also reported that osteopontin was not specific to mesothelioma. A blinded test of soluble mesothelioma-related protein in 817 asbestos-exposed people and 168 mesothelioma patients, described as a manuscript in preparation, gave an area-under-the-curve accuracy score of 0.80. In 49 mesothelioma cases from 3897 asbestos-exposed people in the CARET study, the score was 0.72 one year before diagnosis. The review also covered fibulin-3, a 13-marker panel, and a four-gene test to predict survival after surgery. For lung cancer, it covered microRNAs and DNA sequencing. The authors concluded that thoracic surgeons should be main actors in this molecular era.

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 summarizing expert presentations at a 2013 conference session
• Who was studied: No study population of its own; the review covered research on diagnostic and prognostic markers in malignant pleural mesothelioma (MPM), and on microRNAs and genomic sequencing in lung cancer
• Exposure: Asbestos exposure (no fiber types named), discussed as defining a high-risk group in whom blood tests for mesothelioma could be studied
• Main results:
  • Reported from Jube et al.: serum HMGB1 levels in people with documented asbestos exposure were threefold higher than in people who were not exposed or who were present or former smokers. The review noted HMGB1 is also raised in mesothelioma patients.
  • A blinded validation of soluble mesothelioma-related protein (SMRP) in 817 asbestos-exposed people versus 168 mesothelioma patients (manuscript in preparation) gave an area under the curve of 0.80
  • In the CARET study, 49 mesothelioma cases were diagnosed among 3897 asbestos-exposed people. SMRP in their earlier blood samples gave an area under the curve of 0.72 one year before diagnosis; detection more than one year before was described as unsatisfactory.
  • Osteopontin was found not to be specific to mesothelioma
  • Plasma fibulin-3 in a blinded validation of 48 mesothelioma patients and 96 asbestos-exposed people from the Princess Margaret Cancer Center gave an area under the curve of 0.87
  • The SomaLogic 13-marker panel gave an area under the curve of 0.95 in a blinded independent set of 38 mesothelioma patients and 62 asbestos-exposed people
  • A four-gene prognostic test for mesothelioma was validated in 3 retrospective cohorts and in 1 prospective cohort of 160 patients who had extrapleural pneumonectomy or pleurectomy/decortication
  • For lung cancer, ratios among 24 microRNAs distinguished samples taken at diagnosis or up to 2 years before detection, in people enrolled in two low-dose CT screening trials
• The authors' conclusion: The authors concluded that thoracic surgeons are central participants in molecular thoracic oncology, and that knowledge of genetic mutations is a fundamental part of modern thoracic surgical practice

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: Pleural Mesothelioma, Lung Cancer, Prognosis, Mesothelioma, Biomarker.

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