Use of Serum Mesothelin as an Indicator of Tumor Progression in Routine Clinical Practice of Malignant Pleural Mesothelioma Treatment

Our plain-English summary of Use of Serum Mesothelin as an Indicator of Tumor Progression in Routine Clinical Practice of Malignant Pleural Mesothelioma Treatment, by A. Vigani, M.P. Pistillo, V. Fontana, et al (Journal of Thoracic Oncology, 2018).

The study

• Authors: A. Vigani, M.P. Pistillo, V. Fontana, U. Giannoni, I. Rosenberg, P.A. Canessa, G. Berisso, P. Ferro, M.C. Franceschini, M. Tonarelli, S. Roncella
• Journal: Journal of Thoracic Oncology
• Published: 2018;13(8):e143-e145
• Type of article: Case report, Letter
• Cited by: 1 article, as counted by NIH iCite
• Read it: PubMed · Publisher

In plain English

This letter to the editor described one patient: a 67-year-old man with a history of asbestos exposure who was diagnosed with epithelioid malignant pleural mesothelioma at the authors' hospital in La Spezia, Italy, in August 2013. He received six cycles of cisplatin and pemetrexed and died about 16 months after starting therapy. The authors tracked a blood marker, soluble mesothelin-related peptides (serum mesothelin), alongside CT scan measurements of the thickness of his pleura and of an enlarged lymph node. Before therapy his mesothelin level was 1.23 nM. It fell to a low of 0.50 nM over the next 3 months, then rose until his death. Fifteen days before he died it was 7.71 nM, when his pleural thickness measured 9.4 mm and the short axis of the lymph node measured 20.5 mm. The authors reported a correlation of about 0.95 between mesothelin and pleural thickness, and about 0.80 between mesothelin and lymph node size. The authors concluded that serum mesothelin could be combined with CT images to monitor disease progression. As a single case, it shows what happened to one patient, not how often this occurs.

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: case report (letter to the editor) describing one patient
• Who was studied: one 67-year-old man with a history of asbestos exposure, seen with shortness of breath (dyspnea) and cough in August 2013 at the authors' hospital (La Spezia, Italy, per the author affiliations), diagnosed with epithelioid malignant pleural mesothelioma, UICC stage II
• Exposure: a history of asbestos exposure, with no fiber type, job or dose given. The study's focus was serum soluble mesothelin-related peptide levels, measured with the MesoMark ELISA kit and compared with CT measurements.
• Main results:
  • The patient was treated with six cycles of cisplatin and pemetrexed over 4 months and died about 16 months after starting therapy.
  • Before therapy, the patient's serum mesothelin level was 1.23 nM, his pleural thickness was 1.9 mm and the short axis of the subcarinal lymph node was 5.2 mm.
  • Over the following 3 months the patient's mesothelin level fell slightly to a minimum of 0.50 nM, then kept rising until his death.
  • At month 5, the patient's mesothelin level was 0.96 nM and his pleural thickness was unchanged.
  • At month 5, the subcarinal lymph node had enlarged further, with a short axis of 9.3 mm.
  • Fifteen days before the patient's death, his mesothelin level was 7.71 nM, his pleural thickness was 9.4 mm and the short axis of the subcarinal lymph node was 20.5 mm.
  • In this patient, the Spearman correlation with mesothelin level was about 0.95 for pleural thickness and about 0.80 for lymph node short axis.
• The authors' conclusion: The authors believe serum mesothelin level could be integrated with CT images to monitor progression of malignant pleural mesothelioma.

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: Mesothelin, Pleural Mesothelioma.

Related studies

• The Correlation of Serum Mesothelin Level With Pleural Thickness in Malignant Pleural Mesothelioma Makes it a Valuable Tool for Monitoring Tumor Progression — V. Fontana, A. Vigani, et al. (2019)
• Serum soluble mesothelin concentrations in malignant pleural mesothelioma: relationship to tumor volume, clinical stage and changes in tumor burden — J. Creaney, R.J. Francis, et al. (2011)
• Evaluation of soluble mesothelin-related peptide as a diagnostic marker of malignant pleural mesothelioma effusions: its contribution to cytology — P.A. Canessa, M.C. Franceschini, et al. (2013)
• Malignant Mesothelioma Biomarkers: From Discovery to Use in Clinical Practice for Diagnosis, Monitoring, Screening, and Treatment — J. Creaney, B.W.S. Robinson (2017)
• The relationship between tumor MSLN methylation and serum mesothelin (SMRP) in mesothelioma — H.H. Nelson, L.M. Almquist, et al. (2011)
• Recombinant Immunotoxin with T-cell Epitope Mutations That Greatly Reduce Immunogenicity for Treatment of Mesothelin-Expressing Tumors — R. Mazor, J. Zhang, et al. (2015)

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