Prognostic value of several biomarkers for the patients with malignant pleural mesothelioma

Our plain-English summary of Prognostic value of several biomarkers for the patients with malignant pleural mesothelioma, by H. Liu, L. Wu, K. Ji, et al (Tumour Biology, 2015).

The study

• Authors: H. Liu, L. Wu, K. Ji, W. Wang
• Journal: Tumour Biology
• Published: 2015;36(10):7375-84
• Type of article: Review
• Cited by: 5 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Malignant pleural mesothelioma (MPM) is a highly aggressive tumor of the pleura closely related to asbestos exposure. Rare as it is, the incidence of MPM is predicted to increase mainly as a result of a lengthy latency period from the initial asbestos exposure, making it a public health concern for the next decades. Moreover, the patients with MPM have an extremely poor prognosis due to its high resistance to conventional oncologic treatments and delayed diagnosis. Although the result of current therapeutic modalities based on patient features and clinical stages is very frustrating, great advances have been shown in the knowledge of molecular biology of MPM in recent years. This is accompanied by dozens of putative prognostic biomarkers that are actively involved in tumor biological activities. These prognostic candidates can offer us a new insight into the biological characteristics of MPM, contributing to development of individualized therapeutic strategies directed against oncogenesis and tumor progression. Thus, personalized approaches based on the molecular biology of the patient's tissue or body fluid will potentially improve the present disappointing outcome, bringing new hope for patients with MPM. This article reviews the principal and several novel biomarkers that can have an influence on prognosis, in the hope that they can provide us with a more profound understanding of the biology of this lethal disease.

In plain English

This article was a review, not a new study. The authors summarized published research on markers in blood, pleural fluid and tumor tissue that might predict survival in patients with malignant pleural mesothelioma, a cancer of the pleura (the lining around the lungs). They describe this cancer as closely related to asbestos exposure. They covered soluble mesothelin-related proteins (SMRP), megakaryocyte potentiating factor (MPF) and osteopontin, plus newer markers: fibulin-3, aquaporin 1, CD74, HMGB1 and VEGF. As the review reports them, earlier studies gave mixed results for SMRP, MPF and VEGF. Other studies it cites linked higher osteopontin, higher fibulin-3 in pleural fluid and higher serum HMGB1 with worse survival. Higher aquaporin 1 and CD74 in tumor tissue were linked with longer survival. The authors concluded that no prognostic marker for this cancer is firmly established. They said some markers rest on single studies, and that results for others remain controversial because of small patient numbers and differing study designs, so more validation is needed. The review did not itself measure 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 prognostic biomarkers in malignant pleural mesothelioma
• Who was studied: Published studies of patients with malignant pleural mesothelioma (MPM) examining eight biomarkers: SMRP, MPF and osteopontin (described as the principal markers) and fibulin-3, aquaporin 1, CD74, HMGB1 and VEGF (described as novel markers). The individual studies discussed ranged from 12 patients to more than 100.
• Exposure: No exposure was studied. The review concerns biomarker levels in patients with MPM, a cancer the authors describe as closely related to asbestos exposure. No fiber types are analyzed.
• Main results:
  • SMRP (soluble mesothelin): the reviewed studies disagreed. One cited study (Cristaudo et al.) found higher serum SMRP linked with shorter overall survival in 101 MPM patients. Another cited study of 106 patients found no prognostic significance.
  • The authors judged the SMRP findings inconclusive.
  • MPF: one cited study of 48 patients found serum MPF not informative for outcome. A cited study of 106 patients linked higher MPF with unfavorable prognosis. The authors called these results contradictory.
  • Osteopontin: in a cited study of 91 patients, serum osteopontin above a 350 ng/mL cutoff was a negative prognostic factor for survival.
  • Osteopontin: in another cited study (Cappia et al.), osteopontin in tumor tissue was significantly lower in long-term survivors (n=32) than in short-term survivors (n=69).
  • Fibulin-3: a cited study of 82 patients (Creaney et al.) found that fibulin-3 in pleural effusion was a marker of unfavorable prognosis.
  • Aquaporin 1: a cited study of two cohorts (80 patients who had extrapleural pneumonectomy and 56 treated conservatively) found that aquaporin 1 expression in more than 50% of tumor cells was associated with significantly better survival in both cohorts.
  • CD74: a cited study of 135 MPM specimens found high CD74 expression correlated with longer survival, irrespective of histological subtype.
  • HMGB1: a cited study of 61 MPM patients found that higher serum HMGB1 was significantly linked with shorter survival, using a cutoff of 9 ng/mL.
  • VEGF: the cited studies gave conflicting results on whether VEGF predicts survival.
• The authors' conclusion: The authors concluded that several prognostic biomarkers have been studied but none is firmly established for MPM, and that extensive validation and further research are required.
• Limitations the authors state:
  • The authors note that some of the biomarkers are supported only by single studies.
  • The authors note that results for the other biomarkers remain controversial because the studies were small and differed in design.

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, Pleura, Asbestos Exposure, Latency, Prognosis, Oncogenesis.

Related studies

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• 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)
• Prognostic value of the lymphocyte-to-monocyte ratio and other inflammatory markers in malignant pleural mesothelioma — A.C. Tanrikulu, A. Abakay, et al. (2016)
• Midkine is a potential novel marker for malignant mesothelioma with different prognostic and diagnostic values from mesothelin — G. Ak, Y. Tada, et al. (2017)
• Prognostic value of 18F-FDG standard uptake value by integrated PET/CT in the staging of malignant pleural mesothelioma — G. Genestreti, A. Moretti, et al. (2012)
• Biomarkers and prognostic factors for malignant pleural mesothelioma — P. Vigneri, F. Martorana, et al. (2015)

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