Fibulin-3 as a biomarker for pleural mesothelioma

Our plain-English summary of Fibulin-3 as a biomarker for pleural mesothelioma, by K. Hollevoet, E. Sharon (The New England Journal of Medicine, 2013).

The study

• Authors: K. Hollevoet, E. Sharon
• Journal: The New England Journal of Medicine
• Published: 2013;368(2):189
• Type of article: Letter, Comment
• Cited by: 6 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Summary of the article

In this letter, the authors commented on a study by Pass et al. that had reported fibulin-3 as a new soluble biomarker for malignant mesothelioma. They noted that the diagnostic accuracy of plasma fibulin-3 levels in the Detroit and New York cohorts (area under the receiver-operating-characteristic curve [AUC], 0.99) exceeded that of any previously reported marker. In the external validation cohort, however, accuracy fell to an AUC of 0.87. The authors suggested this decrease was probably due to differences in the study population, although the study had shown no association between plasma fibulin-3 levels and common patient characteristics. They called for research to identify the factors that affect plasma fibulin-3 levels. They pointed out that the AUC of 0.87 was similar to values previously reported for serum mesothelin, which they described as the standard biomarker for mesothelioma (AUC, 0.72 to 0.93). They added that data from matched analyses comparing or combining fibulin-3 with mesothelin were lacking. They concluded that future validation efforts should continue to focus on the performance of fibulin-3 in early-stage disease and should maintain the high standards of the study by Pass et al. In the accompanying reply, Pass and Goparaju reported a post hoc analysis of 29 patients with mesothelioma and 41 patients exposed to asbestos from their Detroit cohort. It showed an AUC of 0.74 for soluble mesothelin-related peptides and 1.0 for fibulin-3.

PubMed has no abstract for this study, and the article doesn't print one. We wrote this summary from the full article with the help of AI. It is not the authors' wording.

In plain English

This item is a letter to the editor, not a new study. The authors, from the National Cancer Institute, commented on a 2012 study by Pass and colleagues of fibulin-3, measured in blood plasma, as a new marker for malignant mesothelioma. The letter noted that in the Pass study, the diagnostic accuracy of fibulin-3 in the Detroit and New York cohorts (area under the curve, or AUC, 0.99) fell in that study's external validation cohort (AUC 0.87). The authors wrote that this drop was probably due to differences in the study population, even though the Pass study found no association between fibulin-3 levels and common patient characteristics. They said researchers should identify the factors that affect plasma fibulin-3 levels. They noted that an AUC of 0.87 is similar to values previously reported for serum mesothelin, which they called the standard mesothelioma marker (AUC 0.72 to 0.93). They added that matched analyses comparing or combining fibulin-3 and mesothelin were lacking. The authors concluded that future validation work should keep focusing on how fibulin-3 performs in early-stage disease. The letter reported no new patient data.

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: letter to the editor commenting on a published study (Pass et al., N Engl J Med 2012)
• Who was studied: No patients studied by the letter's authors; the letter discusses the Detroit and New York cohorts and the external validation cohort of the Pass et al. study
• Main results:
  • The letter notes that in the Pass et al. study, plasma fibulin-3 had an AUC of 0.99 in the Detroit and New York cohorts, which exceeded that of any previously reported marker
  • The letter notes that in the Pass et al. external validation cohort, diagnostic accuracy decreased to an AUC of 0.87
  • The authors wrote that the decrease was probably due to differences in the study population, although the Pass study showed no association between plasma fibulin-3 levels and common patient characteristics
  • The authors said researchers should identify the factors that affect plasma fibulin-3 levels
  • The authors noted that the AUC of 0.87 is similar to previously reported values for serum mesothelin, which they called the standard biomarker for mesothelioma (AUC 0.72 to 0.93)
  • The authors stated that data from matched analyses comparing or combining fibulin-3 with mesothelin were lacking
• The authors' conclusion: The authors concluded that future validation efforts should continue focusing on fibulin-3's performance in early-stage disease and maintain the standards of the Pass et al. study

Topics

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

Medical terms in this study, explained in our Lexicon: Fibulin-3, Biomarker, Pleural Mesothelioma, Malignant Mesothelioma, Mesothelin, Mesothelioma, Soluble Mesothelin-Related Peptides (SMRP).

Related studies

• Fibulin-3 as a blood and effusion biomarker for pleural mesothelioma — H.I. Pass, S.M. Levin, et al. (2012)
• Plasma Fibulin-3 as a Potential Biomarker for Patients with Asbestos-Related Diseases in the Han Population — Z. Jiang, S. Ying, et al. (2017)
• Fibulin-3 as a biomarker for pleural mesothelioma — H.I. Pass, C. Goparaju (2013)
• Fibulin-3 as biomarker of malignant mesothelioma — C. Ledda, R. Caltabiano, et al. (2019)
• Fibulin-3 as a biomarker for pleural mesothelioma — K. Lamote, P. Baas, et al. (2013)
• Comparison of fibulin-3 and mesothelin as markers in malignant mesothelioma — J. Creaney, I.M. Dick, et al. (2014)

Browse more research in The New England Journal of Medicine, or return to medical research.