Mesothelioma diagnosis and treatment has come a long way since 1920, when Drs. Ernest S. Du Bray and F. B. Rosson coined the term "primary mesothelioma of the pleura." Back then, the cause of the disease was unknown and doctors had no idea how to treat it. In fact, back then, because mesothelioma had some of the same symptoms as tuberculosis (TB), many patients were treated with harmful TB medication.
Today, doctors and researchers know that asbestos is the only known cause of mesothelioma and they have developed a number of ways to diagnose and treat the disease. Though treatments are available, there is no cure for mesothelioma. However, early detection could lead to better outcomes.
Early detection is possible with certain blood tests that are used to detect mesothelioma in people who have been exposed to asbestos. The tests work by helping identify elevated biomarkers. Per Caris Life Sciences, “biomarkers are molecules that indicate normal or abnormal processes taking place in your body and may be a sign of an underlying condition or disease. Various types of molecules, such as DNA (genes), proteins or hormones, can serve as biomarkers since they all indicate something about your health. Biomarkers may be produced by the cancer tissue itself or by other cells in the body in response to cancer.”
In addition to being found in the blood, biomarkers can be found in the “stool, urine, tumor tissue, or other tissues or bodily fluids,” says Caris. “Notably, biomarkers are not limited to cancer. There are biomarkers for heart disease, multiple sclerosis, and many other diseases.” Cancer biomarkers can include proteins, gene mutations (changes), gene rearrangements, extra copies of genes, missing genes, and other molecules.
Currently, four blood tests show great promise in helping detect mesothelioma before it advances into the late stages. These tests help detect elevated blood levels of a number of substances that make mesothelioma likely. Some of the most prominent substances include fibulib-3, osteopontin, and soluble mesothelin-related peptides (SMRPs).
The four most promising blood tests for mesothelioma are:
- Fibulin-3 Test
- Human MPF Elisa Kit
MESOMARK is the world’s first serum-based biomarker sensitive for mesothelioma. Developed by Fujirebio Diagnostics, Inc., the blood test is being touted as the latest diagnostic tool to help improve mesothelioma patient care. Per Fujirebio, “the MESOMARK assay is a manual enzyme-linked immunosorbent assay for the quantitative measurement of Soluble Mesothelin-Related Peptides (SMRP). SMRP is a biomarker that is released into the bloodstream by mesothelioma cells. SMRP can be elevated years before an actual diagnosis of mesothelioma is made. By measuring the amount of SMRP present in the bloodstream, the MESOMARK assay will help physicians routinely monitor individuals with the greatest risk of developing mesothelioma due to asbestos exposure.”
If the disease develops, doctors can use MESOMARK to help determine how well patient’s respond to treatment.
SOMAmer was shown to have “excellent” diagnostic accuracy in case-control settings. The test (Slow Off-rate Modified Aptamer (SOMAmer) proteomic test) measures a panel of 13 biomarkers to detect mesothelioma. To date, SomaLogic (the developers of SOMAmer) has developed SOMAmer reagents to a broad array of more than 1,300 different protein targets. The company says that it will continue to expand its SOMAmer reagent library at regular intervals.
Fibulin-3 Test is a new biomarker for malignant mesothelioma (MM). Research shows that testing this biomarker could assist in early detection of malignant mesothelioma. In studies, the test was also effective in detecting the progression of mesothelioma.
Human MPF Elisa Kit measures megakaryocyte potentiating factor (MPF)—a protein encoded in the mesothelin (MSLN) gene. Also known as Human MPF (Maturation Promoting Factor) ELISA Kit, the test can be performed using several kits—the Ab-Match ASSEMBLY Human MPF kit and Ab-Match UNIVERSAL kit, developed by Medical & Biological Laboratories, or the Human N-ERC/Mesothelin Assay kit, developed by Immuno-Biological Laboratories.
Because mesothelioma research and treatment are always evolving, an endless number of tests and treatment options are currently in varying stages of development. As a result, a number of other biomarker tests are either on the horizon, in clinical trials, or already being used. The tests below may also be useful in helping detect a number of different types of cancer or monitor the effectiveness of treatment.
- CA-125 (CTCA) could help detect more than a dozen types of cancer, including peritoneal mesothelioma.
- 8-hydroxy-2′-deoxyguanosine (8OHdG) has been used to estimate the DNA damage in humans after exposure to cancer-causing agents, such as asbestos fibers, tobacco smoke, heavy metals, and polycyclic aromatic hydrocarbons.
- Interleukine-6 (IL-6): IL-6 is a cytokine—a protein produced by immune cells that acts on other cells to help regulate and/or promote an immune response. It also stimulates the production of acute phase reactants, which are proteins that increase in the blood with conditions that cause inflammation or tissue injury.
- Osteopontin: Blood osteopontin levels “rise dramatically" in the early stages of pleural mesothelioma, says top mesothelioma surgeon Harvey I. Pass, MD. Testing these levels could help detect mesothelioma earlier.
- Vascular endothelial growth factor-beta (VEGF-B): Accumulating evidence implicates VEGF in the formation of malignant pleural effusions (MPEs).
If you think that you may have been exposed to asbestos, talk to your doctor about the different types of blood tests for mesothelioma. Early detection could save your life.
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