New Marker May Allow Earlier Mesothelioma Detection

New research reports that the protein fibulin-3 may be able to distinguish pleural mesothelioma from similar lung conditions. Preliminary results indicate that fibulin-3 levels in plasma and effusions are significantly higher in pleural mesothelioma patients. This gives doctors the ability to distinguish people with mesothelioma from asbestos-exposed victims without cancer, and further, to differentiate between mesothelioma and other malignant and benign strains. Pleural mesothelioma is a specific cancer of the tissue that lines the chest cavity and surrounds the lungs. About two thirds of mesothlioma cases develop in this pleural lining. The overall median survival rate for this type of cancer is one year.

Mesothelioma lawyers at Pintas & Mullins Law Firm stress the importance of detecting mesothelioma in its early stages, when treatment is most valuable. Catching mesothelioma early is notoriously difficult, and is the major reason for the cancer’s poor prognosis. A long latency period (20 to 50 years) and lack of reliable detection methods also contribute to late diagnosis. The current biomarker for mesothlioma is a soluble mesothelin-related protein, however the test for it often produces false negatives, rendering those afflicted with mesothelioma to continue longer and longer without treatment. This new biomarker will enable doctors to individualize mesothelioma treatment strategies.

In the New England Journal of Medicine Study, Dr. Harvey Pass and his colleagues identified fibulin-3, a protein important in cell-to-cell and cell-to-extracellular matrix signaling, as a potential mesothelioma marker.

The researchers measured fibulin-3 levels in plasma and pleural effusion samples from 142 patients with mesothelioma, 136 cancer-free individuals exposed to asbestos and 93 patients with effusions not due to mesothelioma. The researchers also evaluated plasma samples from 91 patients with cancers other than mesothelioma and 43 healthy control subjects. Many of these samples came from Early Detection Research Network.

Average plasma fibulin-3 levels were higher in patients with mesothelioma than in people without cancer who had been exposed to asbestos. Patients with mesothelioma and those without the disease could be distinguished with a sensitivity of 96.7 percent and a specificity of 95.5 percent at a cutoff level of 52.8ng/ml of plasma fibulin-3.
The researchers used another cohort of plasma samples to validate their findings, though the sensitivity and specificity fell to 72.9 percent and 88.5 percent, respectively.

Plasma fibulin-3 levels may also be helpful in monitoring response to therapy and disease progression. In 18 patients, fibulin-3 levels fell after surgery, and there was a trend toward rising fibulin-3 at the time of disease progression in 6 of these patients.

Fibulin-3 levels were higher in effusion samples than in plasma samples. In the few patients with both plasma and effusion samples, there was no clear relationship between the fibulin-3 levels in the two locations. Effusion fibulin-3 levels, however, were able to distinguish patients with mesothelioma from those with effusions not related to the disease, a welcome finding as it is difficult to distinguish patients with mesothelioma from those with benign effusions or malignant effusions due to other cancer types.

Likewise, effusion fibulin-3 levels were lower in patients with stage I or II mesothelioma than in those with stage III or IV disease. Patients with the highest effusion fibulin-3 levels at the time of surgery had shorter survival times.

The results are promising, though more studies involving a larger number of patients and prospective studies are needed to validate fibulin-3 as a biomarker for mesothelioma.

Dr. Raffit Hassan of NCI’s Center for Cancer Research notes that “the other important thing would be to see if the levels of fibulin-3 could be used as a biomarker for response to chemotherapy or other biological therapies,” he said. “Since mesothelioma is a very difficult disease to measure radiologically, it would be nice to have a sensitive and specific assay for monitoring response to treatment.”

We at Pintas & Mullins Law Firm are hopeful that this new biomarker will save the lives of those affected by asbestos exposure. If you or a loved one has developed mesothelioma or any other asbestos-related illness, contact an asbestos attorney today to explore your legal rights and potential claims.


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