Soluble mesothelin-related peptides levels in patients with malignant mesothelioma

Our plain-English summary of Soluble mesothelin-related peptides levels in patients with malignant mesothelioma, by A. Franko, V. Dolzan, V. Kovac, et al (Disease Markers, 2012).

The study

• Authors: A. Franko, V. Dolzan, V. Kovac, N. Arneric, M. Dodic-Fikfak
• Journal: Disease Markers
• Published: 2012;32(2):123-31
• Cited by: 21 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Soluble mesothelin-related peptides (SMRP) are a potential tumor marker for malignant mesothelioma. The aim of this study was to determine the differences in SMRP levels in patients with malignant mesothelioma before treatment and in various responses to treatment and to investigate whether SMRP level could be useful in evaluating tumor response to treatment. The study included patients with malignant mesothelioma treated at the Institute of Oncology Ljubljana between March 2007 and December 2009. Blood samples were collected before treatment and/or in various responses to treatment. SMRP levels were determined using ELISA assay based upon a combination of two monoclonal antibodies. Mann-Whitney test was used to determine the differences in SMRP levels in various responses to treatment. Median SMRP was 2.80 nmol/L (range 0.00-34.80) before treatment, 0.00 nmol/L (range 0.00-0.00) in complete response, 0.48 nmol/L (range 0.00-4.40) in partial response, 1.65 nmol/L (range 0.00-20.71) in stable disease and 7.15 nmol/L (range 0.44-31.56) in progressive disease. Pre-treatment SMRP levels were significantly higher than in stable disease, partial response and complete response (p=0.006), as were SMRP levels in progressive disease compared to stable disease, partial response and complete response (p< 0.001). Our findings suggest that SMRP may be a useful tumor marker for detecting the progression of malignant mesothelioma and evaluating tumor response to treatment.

In plain English

This study measured soluble mesothelin-related peptides (SMRP), a blood protein proposed as a tumor marker, in all 78 patients with malignant mesothelioma (70 pleural, 8 peritoneal) treated at the Institute of Oncology Ljubljana, Slovenia, from March 2007 to December 2009. The authors collected 134 blood samples before treatment, after treatment or at disease progression. They compared levels across patients rather than within each patient. Median SMRP was 2.80 nmol/L in 37 pre-treatment samples, 0.00 in 4 samples taken at complete response or after surgery, 0.48 at partial response, 1.65 at stable disease and 7.15 in 45 samples at progressive disease. Levels before treatment, and levels in progressive disease, were each significantly higher than the combined levels in stable disease, partial response and complete response. Pre-treatment levels showed no correlation with survival. The authors concluded that SMRP may be a useful marker for detecting progression and evaluating treatment response. They noted the small number of patients and said it remains an open question whether SMRP suits routine evaluation of individual cases.

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: Cross-sectional prospective study of serum SMRP levels at different phases of treatment and disease
• Who was studied: All 78 patients with malignant mesothelioma (70 pleural, 8 peritoneal) treated at the Institute of Oncology Ljubljana, Slovenia, March 2007 to December 2009. A total of 134 blood samples were collected, 1 to 4 per patient.
• Exposure: The study's main measurement was serum SMRP, not asbestos. Occupational and/or environmental asbestos exposure was also assessed for every patient: 17 were asbestos-cement factory workers with cumulative exposure estimates, and the others were assessed from work histories. Exposure was grouped as low (24 patients), medium (21), high (22) and none (11). No fiber types are named for the patients.
• Main results:
  • Median SMRP by sample group: 2.80 nmol/L before treatment (37 samples, range 0.00 to 34.80); 0.00 in complete response or after surgery (4 samples); 0.48 in partial response (13 samples, range 0.00 to 4.40); 1.65 in stable disease (35 samples, range 0.00 to 20.71); 7.15 in progressive disease (45 samples, range 0.44 to 31.56). Medians were highest in progressive disease and before treatment.
  • Pre-treatment SMRP levels were significantly higher than the combined levels in stable disease, partial response and complete response (U = 662.50, p = 0.006).
  • SMRP levels in progressive disease were significantly higher than the combined levels in stable disease, partial response and complete response (U = 332.00, p less than 0.001).
  • Using a cut-off of 1.50 nmol/L, 23 pre-treatment samples (62.2%) were above the cut-off. None of the complete-response samples were above it.
  • Above the 1.50 nmol/L cut-off were 6 partial-response samples (46.2%), 18 stable-disease samples (51.4%) and 41 progressive-disease samples (91.1%).
  • Before treatment, SMRP levels in the epitheloid subtype were significantly higher than in the combined biphasic and sarcomatoid subtypes (U = 75.00, p = 0.020).
  • In patients with pleural mesothelioma, pre-treatment SMRP levels did not differ significantly between tumor stages. They also did not differ significantly between patients with and without metastatic disease (p = 0.09), although the median was higher with metastatic disease.
  • No correlation was found between pre-treatment SMRP levels and survival.
  • Serum creatinine, measured because kidney failure can raise SMRP, was within reference ranges in all samples.
• The authors' conclusion: The authors concluded that SMRP may be a useful tumor marker for detecting progression of malignant mesothelioma and for evaluating tumor response to treatment, and that more cases are needed to confirm this.
• Limitations the authors state:
  • The number of patients was small, and SMRP levels were compared across patients rather than as changes within the same patients.
  • More cases are needed to increase the study's statistical power.
  • Whether SMRP is a good marker for routine evaluation of treatment response in individual patients remains an open question.

Topics

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

Medical terms in this study, explained in our Lexicon: Soluble Mesothelin-Related Peptides (SMRP), Malignant Mesothelioma, Tumor Marker, Monoclonal.

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• Evaluation of soluble mesothelin-related peptides and MSLN genetic variability in asbestos-related diseases — K. Goricar, V. Kovac, et al. (2020)
• Two novel polymorphisms in 5' flanking region of the mesothelin gene are associated with soluble mesothelin-related peptide (SMRP) levels — A. Cristaudo, R. Foddis, et al. (2011)
• Mesothelin promoter variants are associated with increased soluble mesothelin-related peptide levels in asbestos-exposed individuals — C. De Santi, P. Pucci, et al. (2017)
• Serum levels of soluble mesothelin-related peptides in malignant and nonmalignant asbestos-related pleural disease: relation with past asbestos exposure — J.A. Rodríguez Portal, E. Rodríguez Becerra, et al. (2009)
• Soluble mesothelin-related peptide level elevation in mesothelioma serum and pleural effusions — H.I. Pass, A. Wali, et al. (2008)

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