In July, MesotheliomaHelp reported on a phase I clinical trial where various cancers, including mesothelioma, were being tested for the safety and tolerability of the drug avelumab. Now, the maker of the drug reports the U.S. Food and Drug Administration has granted accelerated approval to Bavencio (avelumab) for the treatment of patients with metastatic Merkel cell carcinoma (MCC).

EMD Serono Inc. reports the approval was based on the results of the JAVELIN clinical trial where of 88 patients with MCC who had been previously treated with at least one chemotherapy regimen, 33 percent experienced complete or partial shrinkage of their tumors. The response lasted for more than six months in 86 percent of responding patients and more than 12 months in 45 percent of responding patients, according to the FDA.

The scientific community continues to make advances targeting the bodys immune system mechanisms for the treatment of various types of cancer, Richard Pazdur, MD, of the FDA office of hematology and oncology products, said in a March 23 press release. These advancements are leading to new therapies even in rare forms of cancer where treatment options are limited or non-existent.

Bavencio is an investigational immunotherapy drug that targets the PD-L1 protein. The drug works by blocking signals from PD-L1 tumors, activating the immune system, allowing it to take over and attack and kill cancer cells. Merck KGaA, Darmstadt, Germany, and Pfizer have formed a strategic alliance to co-develop and co-commercialize the drug. This is the first FDA-approved therapy for patients with MCC.

Metastatic MCC is a rare and aggressive skin cancer, with fewer than half of patients surviving more than one year and fewer than 20% surviving beyond five years.

Like MCC, mesothelioma is a rare, orphan disease that is challenging to treat and often recurs in patients. Prognosis for mesothelioma is often less than 18 months. With an initial positive result for mesothelioma patients with this drug in the JAVELIN clinical trial, the mesothelioma community is hoping for continued positive results that could lead to a new treatment for patients with the asbestos-caused cancer.

According to the FDA, Accelerated Approval enables the FDA to approve drugs for serious conditions to fill an unmet medical need using clinical trial data that is thought to predict a clinical benefit to patients.

Bavencio also received Orphan Drug designation, which provides incentives to assist and encourage the development of drugs for rare diseases.

Today is a significant milestone for people fighting metastatic Merkel cell carcinoma, who until now have not had any options beyond chemotherapy, said Albert Bourla, Group President, Pfizer Innovative Health in a March 23 press release. This approval demonstrates the power of collaboration to accelerate meaningful new choices for cancer patients.

Pleural mesothelioma is a terminal cancer of the lining of the lungs caused by past exposure to asbestos. The cancer is diagnosed in nearly 3,000 Americans each year.

For more information about the ongoing JAVELIN clinical trial see ClinicalTrials.gov.

Nancy is a blog and content writer with more than 20 years of professional experience. Nancy has been writing about mesothelioma and cancer for close to eight years.

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Accelerated Approval Granted to Drug in Mesothelioma Research Pipeline - MesotheliomaHelp.org (blog)

Malignant mesothelioma is a rare type of cancer that occurs in the thin layer of cells lining the body's internal organs, known as the mesothelium.

There are three recognized types of mesothelioma. Pleural mesothelioma is the most common form of the disease, accounting for roughly 70% of cases, and occurs in the lining of the lung known as the pleura. Peritoneal mesothelioma occurs in the lining of the abdominal cavity, known as the peritoneum and pericardial mesothelioma originates in the pericardium, which lines the heart.

An individual may be at risk to develop mesothelioma if he or she was exposed to asbestos in the workplace or at home. Mesothelioma is caused by exposure to asbestos and the inhalation of asbestos particles. In most cases, mesothelioma symptoms will not appear in an individual exposed to asbestos until many years after the exposure has occurred. Those with a past asbestos exposure history experiencing symptoms should consult a physician with experience in accurately diagnosing mesothelioma. The earlier mesothelioma is diagnosed, the more likely it is to be caught at an early stage. At earlier stages of mesothelioma progression, more treatment options are available and oftentimes a better prognosis is given.

Additional mesothelioma information and statistics can be found in this section. Read stories of hope from mesothelioma surviviors as well.

Once an individual has been diagnosed by a qualified mesothelioma doctor, the next step is to discuss mesothelioma treatment options and to develop a treatment plan. Recent scientific research has produced significant breakthroughs with regard to treatment protocols for mesothelioma patients and more options are now available for managing mesothelioma and supporting improved quality of life. Newly diagnosed mesothelioma patients often have many questions for their doctors about the treatment options that would be most effective for them. Conventional treatment options for mesothelioma include surgery, radiation and chemotherapy. Recently, chemotherapy drugs including Alimta and Cisplatin have showed promising results in some patients.

Mesothelioma clinical trials as well as experimental treatments are other options that certain mesothelioma patients may be eligible to participate in. Our site features a comprehensive mesothelioma cancer treatment section that includes important information for patients and families. We've included resources on top mesothelioma experts such as Dr. David Sugarbaker and Dr. Raphael Bueno, as well as a comprehensive list of cancer centers where mesothelioma treatment takes place. Beyond the conventional treatments for mesothelioma, certain alternative therapies may provide assistance to mesothelioma patients. Financial assistance is available to help offset mesothelioma treatment costs. We continually update this section of our site as new mesothelioma treatment information becomes available.

In 2006, at the age of 36, Heather Von St. James gave birth to her daughter, Lily Rose. Just three months later, she was diagnosed with mesotheliomastartling news for someone so young. Heather had been exposed to asbestos second-hand as a child when her father would return home from work with his clothing covered in asbestos dust. Heather often wore his coat, and in the process she unwittingly breathed in the fibers. With strong faith, support from a host of family and friends, and a vibrant sense of humor, Heather emerged from a multi-month course of treatment healthy and cancer-free.

Louise Lou Williams was exposed to asbestos as a child in Australia (where her father was exposed through his work), and also during the three years she worked in a contaminated Melbourne office. Her father died of mesothelioma in 1985, and Lou herself was diagnosed with peritoneal mesothelioma in 2003 following eight years of unexplainable chronic fatigue and a year and a half of being misdiagnosed. After beating that cancer, Lou was diagnosed with pleural mesothelioma in 2009. She now continues her personal fight against mesothelioma while at the same time devoting herself to activism.

Paul Kraus

Paul Kraus has lived with peritoneal mesothelioma for nearly two decades. Born into a Nazi labor camp in Austria, he escaped as an infant with his mother and brother and soon emigrated with his family to Australia. Asbestos is prevalent in Australia, and as a result, the country suffers from some of the highest rates of mesothelioma in the world. Mr. Kraus was exposed as a youth on a summer job he took in 1962. The cancer was latent until 1997 at which time he was diagnosed and given just weeks to live.

Stephen Jay Gould

One of the most popular scientific authors of recent times, evolutionary biologist Stephen Jay Gould, authored more than 20 books on a variety of scientific subjects, and published hundreds of essays in Natural History magazine. Gould lived for twenty years after being diagnosed with mesothelioma in 1982. After his diagnosis, he wrote an essay, The Median Isnt the Message, about his reaction to the news and to the realization that half of all mesothelioma patients died within eight months of diagnosis. His essay has been cited as a source of comfort and hope by many cancer victims.

Asbestos exposure is the primary cause of mesothelioma cancer. Inhaled or ingested asbestos fibers may cause an inflammation of internal tissue and disrupt organ function which leads to the development of mesothelioma. Asbestos products were used extensively in the 20th century throughout the United States, in a wide variety of applications. Asbestos companies continued to produce these products even after they were known to be hazardous to workers. These products were responsible for asbestos exposure sustained by the individuals who manufactured them as well as those who used them. Renovation and construction both at home and in schools also poses high risk areas for exposure. People also may have been exposed to asbestos-contaminated talc in baby powder

Many workers were put at risk at commercial and industrial locations including refineries, power plants, steel mills, auto production facilities and large construction sites. Some of the occupations of workers at risk include electricians, plumbers, boilermakers, carpenters, mechanics, machinists and more. Additionally, if you lived with someone who was regularly exposed to asbestos and washed their clothes, you could be at risk for second hand asbestos exposure.

Although rare, mesothelioma affects veterans from all branches of service: Army, Navy, Air Force, Marines and Coast Guard. As mesothelioma has a long latency period and can remain dormant for several decades, veterans who served our country from 1930 through 1980 are just now being diagnosed with the disease.

Navy veterans who worked in navy shipyards and or served on our nation's aircraft carriers, battleships, destroyers, submarines and warship from WWII through the Vietnam War were exposed to high concentrations of deadly asbestos and are at a high risk for developing asbestos related cancer. Boiler rooms, engine rooms, sleeping quarters, and other areas of naval vessels were the most common areas where asbestos was present. Some prominent shipyards where asbestos was prevalent include Brooklyn Navy Yard, Norfolk Navy Shipyard, Long Beach Naval Shipyard and Hunters Point Naval Shipyard. Financial assistance and help with VA Benefits is available to veterans diagnosed with mesothelioma.

Asbestos manufacturers and distributors made a concerted effort to hide the dangers of asbestos from the public, while at the same time profiting heavily from the sale and manufacture of harmful asbestos products. Those suffering from Mesothelioma can seek compensation from the manufacturers of asbestos and asbestos-containing products by hiring a competent mesothelioma lawyer.

When deciding whether or not you should pursue your legal rights, you should think about the following three things. First, asbestos manufacturers had knowledge of the dangers of asbestos and knowingly put hardworking men and women at risk. Second, treatment for mesothelioma can be very expensive. Third, by exercising your legal rights, you can protect your loved ones in the future.

Once you make the decision to pursue your rights, a competent asbestos attorney will maximize recovery from both viable and bankrupt asbestos defendants. Over 65 asbestos trusts have been established holding billions of dollars combined across them. These asbestos trust funds have been set aside to help compensate those workers who have been diagnosed with mesothelioma cancer or other asbestos related diseases. The legal process to compensate mesothelioma victims is not overly burdensome and should be strongly considered to help offset treatment costs and to provide financial security for loved ones.

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Mesothelioma | Overview, Treatment Options and Survivor Stories

As my fathers caregiver, Mom had a way that was all her own.

She was attentive and loving, while still supporting his independence. She never patronized him and always expressed desire to attend to his needs.

Mom always made caregiving look easy, but I know how difficult it is to care for someone who has advanced mesothelioma. She had a natural skill for taking care of Dad.

She learned how to be a caregiver through experience. Mom never went to medical school or worked in the medical field. She was a homemaker who loved her husband and children.

Her style of caregiving seemed instinctual she just knew what to do when Dad got sick. I never understood how until I studied psychology.

Doctors study medicine for years to develop their style of practice. They develop a sense of responsibility for their patients, and that helps define their style.

Being a family caregiver is a more personal experience than providing medical care for a random patient. They have a love for family and an inner desire to care for their loved ones.

If a physician develops a style through education, experience and their personality, one might wonder what makes up a caregivers style. Most caregivers dont have formal training that teaches them how to interact with their loved one.

Perhaps family caregivers style is more natural more intrinsic than a doctors learned behaviors.

While researching John Bowlby and Mary Ainsworths attachment theory, I came across an article that explores the significance of attachment styles in caregiving.

Attachment styles are bonds developed during infancy and early childhood through infant and caretaker relationships. This type of bonding serves as a model for future relationships in adult life.

In essence, attachment styles influence how we treat others and how we expect others to treat us.

Most people in the developmental psychology community recognize several styles of attachment, including secure, avoidant and resistant. These childhood bonds may have implications in how caregivers will care for a sick loved one later in life.

Our caregiver style is linked to who we are as a person and how we relate to others.

However, a persons caregiving style doesnt fit neatly into any one category. Rather, the styles represent behavioral tendencies that exist on a more fluid spectrum.

We all have days where we are better equipped to provide for the needs of others and face other times when we could use a little help.

Many caregivers fall somewhere within these styles:

Just as a childs behavior might fluctuate depending on outside influences, so does the behavior of a caregiver.

Stress plays a significant role in caregiver responses. The important thing to remember is communication. Sometimes our loved one might need us to be more attentive. Other times, they might be focused more on maintaining independence.

As caregivers, we need to be flexible and sensitive to their needs.

No one is perfect, not even medical professionals. Our loved ones recognize us as human beings who are providing care from the heart.

Very few family caregivers have professional medical training. They learn from on-the-job experience. They provide care not with precision medical skills, but with their hearts.

Perhaps author Kahlil Gibran captures the spirit of a caregiver best when he writes, You give but little when you give of your possessions. It is when you give of yourself that you truly give.

Caregivers reserve the best of themselves for those they love. There is not a more rewarding relationship than one deepened through caregiving.

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Understanding Mesothelioma Caregiver Styles - Asbestos.com (blog)

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People have inhaled cannabinoidsfor many generations, from the Scythians through its banby the federal U.S. government, and beyond.

Now we find that patients suffering from mesothelioma cancer can use medicinal marijuana as a means to reduce their troublesome symptoms. Many are beginning to personally explore the helpful aspects of this natural medicine as researchers continue their quest toward a cancer cure.

Mesotheliomaiscancerof the mesothelium, a protective lining found onmost of the bodys internal organs. Three out of every four cases cases of mesothelioma disease begin in the pleural mesothelium of the chest cavity. Mesothelioma can also begin in the abdominal cavity and around theheart.

Some common signs and symptoms of Mesothelioma include coughing, shortness of breath, fatigue, weight loss and poor respiratory function. Most early-stage patients are not aware that they are carrying the cancer or have developed Mesothelioma because its symptoms overlap with many other health conditions.

Increasing appetite

According to theAmerican Cancer Society, marijuana improves a cancer patients appetite. Although the cellular function is still vague, this plant seems to trigger neurons that deal with taste and hunger.

Mesothelioma and other cancer patients need to eat during their treatment because the nutrients boost their fight against the ailment. However, treatment procedures typically cause nausea and a strong feeling to avoid food. Medicinal cannabis can be the answer to an upset stomach.

Reducing overall pain

Some cancer patients report a lot of pain in their bodies both during and after chemotherapy. Pain is incredibly debilitating, and it can have ill effects on a patients prognosis. Cannabis is known to dull the pain in the body, which helps anypatient with cancer. Researchers believe that the plant works at the cellular level to block pain signals across the axons. Depending on the cannabiss potency, a patient can feel relaxed for an hour or more with just a little bit of the plant in the body system.

Lifting the mood

When a person fights cancer, a negative mindset can be detrimental to the treatment. Cannabis is known to lift the spirits of anyone taking the substance. The subsequent high allows the person to feel good for an hour or longer. If the person continues to take the substance, this high and positive feeling can be extended. Good moods benefit the person so that they can fight off any more cancer tumors.

Possible ailment relief

TheNational Cancer Institutereports that laboratory test results reflect the direct relationship between declining cancer cells and cannabis use. Although more studies must be conducted, its possible that patients might have some cure to their ailment through this common weed. Patients simply need to inhale or consume the substance in order to see these possible results. Researchers are still concluding whether smoking or eating the cannabis is the best choice. The body must metabolize the substance in different ways, and its possible that eating or smoking it is better or worse for a condition.

Although the federal government still deems this plant as a Schedule 1 controlled substance, many states have medicinal laws that override this rule.Cancer patientsmay want to explore their options with this medicine in order to ease their symptoms. Dealing with cancer is difficult, but it can be tolerable with a natural substance offered through legal pathways.

You can contactVirgil Anderson at[emailprotected]

Virgil Anderson is a mesothelioma patient who blogs about his battle with the disease.

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Mesothelioma Patients Turn to Cannabis - AlterNet

One of the most stressful aspects of living with mesothelioma is the fact that the condition carries such a grim prognosis: whether you have been diagnosed with pleural mesothelioma, peritoneal mesothelioma, or the even rarer forms that impact the heart or testicles, most physicians will indicate that the survival rate for the disease is little more than on year. But according to recent reporting by the University of Maryland Medical Centerfollowing a 2016 study, improvements in interventions and treatments have provided an overall median survival rate of almost 3 years. Though this is still a critical diagnosis, it also represents a dramatic improvement for those who have been diagnosed with this disease.

The report followed 73 pleural mesothelioma patients who were treated using a variety of protocols. All of them had surgery to debulk and remove the cancerous tumors, and each was then treated with photodynamic therapy, an innovative treatment approach that uses light and a light-sensitized drug to provide more extensive treatment of cancer cells that remain. Following these two protocols, 92% of patients also received chemotherapy.

This multimodality approach yielded remarkable results. As compared to patients who only had chemotherapy and only lived for 12 to 18 months following treatment, those who receivedall three treatments lived an average of 35 months, and those whose mesothelioma had not yet spread to their lymph nodes lived nearly twice that long.

In addition to this information, other updates in survival and treatment options are revealing growing understanding of the condition. According to a 2015 study published in the Journal of Cardiothoracic, a recent study found that patient survival could reliably be predicted based upon the mesothelioma tumor volume. A study published in theAnnals of Thoracic Surgery revealed a remarkable difference in survival rates betweenwomen and men with mesothelioma, with male patients having a 4.5% survival rate compares to 13.4% in women.

Overall, mesothelioma physicians and advocates are encouraged by the improvements that are being made in patient survival through expanded treatment options, but also feel that the science has a long way to go. For those who are living with mesothelioma on a daily basis, the Patient Advocates at Mesothelioma.net can provide you with updates on available treatments as well as other resources that may help you in your journey. Contact us today at1-800-692-8608.

Terri Oppenheimer is an independent writer, editor and proofreader. She graduated from the College of William and Mary with a degree in English. Her dreams of a writing career were diverted by a need to pay her bills. She spent a few years providing copy for a major retailer, then landed a lucrative career in advertising sales. With college bills for all three of her kids paid, she left corporate America for a return to her original goal of writing. She specializes in providing content for websites and finds tremendous enjoyment in the things she learns while doing her research. Her specific areas of interest include health and fitness, medical research, and the law.

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Mesothelioma Survival Rates Slowly Improving - Mesothelioma.net Blog (blog)

U.S. military veterans with malignant pleural mesothelioma can rely on the VA Boston Healthcare Systems national phone triage for improved access to specialized surgical advice and better treatment recommendations, according to a retrospective study.

Thoracic surgeons Drs. Abraham Lebenthal and Jeff Siegert helped establish the open access telephone triage in 2011, shortening the average time between a veterans initial phone screen and face-to-face surgical consultation to 14 days.

Many veterans facing a potential diagnosis of mesothelioma must navigate the historically mismanaged federal agency to get the treatment they need. Because of difficulties reaching a specialized doctor at the VA, they often settle for less than optimal care, which may lead to shorter survival.

Lebenthal and Siegert hope the telephone triage program will change that.

Open access phone triage for veterans with MPM is possible, enabling timely specialized evidence-based care national, the study shows. We demonstrated that in a federal system, a multidisciplinary team of experts can be assembled and motivated to deliver quaternary centralized care that is typically possible only in a handful of elite teaching hospitals.

Veterans typically are seen first at their local VA health care facility or at an out-of-network medical center. If they suspect pleural mesothelioma is the problem, they can start the process.

The typical telephone triage follows these steps:

The entire telephone triage process, from the veterans first call to the Boston VA final diagnosis, takes an average of 14 days.

The study included 60 U.S. military veterans all men from 26 states who had called the telephone triage for treatment advice about malignant pleural mesothelioma. A dozen more men had called, but they were excluded from the study because they were not U.S. veterans.

All these veterans had already received initial treatment recommendations from their local tumor boards.

After researchers and doctors in Boston gathered and reviewed local test results and confirmed mesothelioma diagnosis, 38 of these veterans traveled to the Boston VA hospital for additional tests.

Once there, treatment recommendations from the Boston VA doctors varied greatly from what the local tumor boards initially suggested.

For example, the local tumor boards suggested 21 patients receive only chemotherapy, but the Boston VA determined only four patients needed that treatment.

Another four patients were initially recommended multimodal therapy, a successful treatment using combinations of radiation, chemotherapy or surgery. But the Boston VA doctors said 29 patients who called the phone triage would benefit from that type of treatment.

Additional tests showed four patients initially diagnosed with the disease didnt even have mesothelioma.

One surprising thing from this study is that we were able to move veterans around the country within the VA system pretty effectively, Siegert said. And for a heckuva lot less money than if you werent a veteran. We used the system already in place, and it worked.

The Boston VA shares staff and facilities with the nearby Brigham and Womens Hospital, which is an elite, multidisciplinary center for mesothelioma patients.

The VA health care system pays for the travel, which is considerably less expensive than sending the patient to a local out-of-network facility. The Boston VA has complimentary housing for its out-of-town patients and families.

By doing everything here, we can bypass a lot of the things that would happen so slowly in the system normally, Siegert said. If a patient gets a first whiff that it could be mesothelioma, we can abbreviate the time vastly, and that pays off for the veteran.

Although the definitive diagnosis, aggressive surgery and aftercare for mesothelioma takes extra staff, effort and knowledge, the Boston VA can simplify the process with its resources already in place at Brigham.

Mesothelioma is a disease so much different than any other, Siegert said. The treatment is so specialized. It requires so much work just to diagnose it, let alone treat it. You cant expect these other facilities to have all that.

One surprising aspect of the study was the nontraditional referral of the patients.

Only 24 percent were referred by a medical provider. The majority used internet resources, such as Asbestos.com, or they were self-referred.

As a physician, I had always gotten patients the old-fashioned way, from other doctors, he said. But thats not the algorithm anymore. Not for this disease.

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Veterans with Mesothelioma Benefit from Telephone Triage - Asbestos.com

Jillian Duff covers pressing news for the Mesothelioma Cancer Alliance. Bio

March 24, 2017

Libby, Montana - While many people are concerned about the new health care bill supported by Republicans, one provision stands out as a continued benefit for mesothelioma patients and other victims of asbestos exposure. Specifically, a special provision in the proposed piece of legislation, known as the American Health Care Act (ACHA), will provide support to those who live in Libby and were exposed to asbestos from the former W.R. Grace & Co. mine.

It is well known that W.R. Grace Company illegally dumped industrial waste containing large amounts of asbestos at several of their facilities in Libby. The vermiculite it contained is a naturally occurring mineral used in the production of insulating materials. The vermiculite ore also contained tremolite asbestos, which is extremely toxic.

During the mines 70 years of operation, the ore was shipped to more than 50 processing plants throughout North America. Much of the Libby vermiculite was used to produce Zonolite attic insulation, but was also used in surfacing materials, window glazing compounds, waterproofing compounds, cements, adhesives, and plaster.

Senator Steve Daines (R-Montana) was a major factor in the inclusion of this provision in the ACHA. The Affordabla Care Act (ACA), popularly known as Obamacare, included similar medical-care benefits for these patients effective in 2011. The new bill likewise includes ongoing screening and Medicare coverage for those diagnosed with asbestos disease as a result of living or working in Libby.

In 1999, the U.S. Environmental Protection Agency (EPA) launched an investigation of the Libby mines and surrounding communities. Those afflicted with asbestos disease not only included miners and mill workers, but also their families and neighbors who were exposed to ore dust which contained tremolite asbestos. This deadly mineral invaded every aspect of life in Libbyair, water, clothing, and food.

Mesothelioma cancer is one of the asbestos diseases that resulted. Treating this type of cancer is very expensive and the survival rate is poor.

Thousands of people have benefited from the Libby provisions. This includes 4,500 new people being screened for asbestos disease at the Center for Asbestos Related Disease (CARD) clinic with over 2,000 individuals being diagnosed. As many as 1,846 victims under 65 years old have Medicare support as part of these provisions, and around 1,300 people are in the pilot program.

Even with these provisions, however, the ACHA could still be detrimental to mesothelioma patients and their families, especially for those patients who could lose their health care coverage under the new legislation. Outside of Libby, thousands of people each year are diagnosed with mesothelioma and are faced with the need to pay for critical cancer treatment. It is unclear at this point whether the Republicans have enough support to pass the ACHA in the House of Representatives.

Earlier this year, the EPA gave its final call for residents to request asbestos inspections in Libby. Financial assistance was offered in instances where an inspection uncovered the need to clean up asbestos from a property. If not cleaned up, it poses a health risk to even more Libby residents.

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Pembrolizumab shows promise in treatment of mesothelioma Science Daily Malignant pleural mesothelioma is a rare and aggressive cancer that represents about 90 percent of all malignant mesothelioma cases. It's primarily caused by the inhalation of asbestos, a fiber commonly found in some forms of insulation, vinyl floor ... and more »

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Pembrolizumab shows promise in treatment of mesothelioma - Science Daily

A biomarker called soluble mesothelin related peptide (SMRP) may be a more reliable way to diagnose malignant pleural mesothelioma from lung fluid than the protein fibulin-3.

That is the finding of Italian researchers who tested the diagnostic performance of the two markers in 120 patients, including 33 mesothelioma patients, in an effort to resolve what they call conflicting data on the two methods.

SMRPs are produced by the breakdown of proteins in the membranes surrounding the lungs, heart, and abdomen. The amount of SMRP in the blood is thought to be related to the extent of malignant mesothelioma in the body.

Fibulin-3 (FBLN) is an extracellular matrix protein expressed in the membranes of blood vessels. A 2012 study published in the New England Journal of Medicine suggested that measuring the amount of FBLN3 in the plasma of people with pleural mesothelioma could help distinguish them from people with pleural effusions not due to mesothelioma.

Subsequent studies, however, have found FBLN3 potentially more useful for predicting how well a patient is likely to respond to mesothelioma treatment, than as a diagnostic tool.

In their new study, cancer researchers with Italys regional health service in La Spezia compared the diagnostic accuracy of FBLN3 and SMRP in patients with excess lung fluid called pleural effusions. The buildup of fluid around the lungs can be caused by a malignancy like pleural mesothelioma or by a non-malignant condition.

To assess how the biomarkers performed in both types of conditions, the research team included 33 patients with malignant pleural mesothelioma, 64 patients with benign tumors on their pleural membranes and 23 patients with other types of cancer that had metastasized to the pleura.

Levels of FBLN3 were similar inpleural effusions from malignant pleural mesothelioma and pleural effusions from other pathologies, writes clinical pathology researcher Enrico Battolla. [This is] in contrast to SMRP levels, which were significantly higher in pleural effusions from malignant pleural mesothelioma.

The team concluded that FBLN3 was not useful as a diagnostic biomarker in the pleural effusions of people with malignant pleural mesothelioma since it was unable to discriminate mesothelioma from other causes of pleural effusions.

SMRP, on the other hand, was determined to be useful, a finding consistent with previous studies. Even with biomarkers for guidance, diagnosing mesothelioma remains a complex process, involving imaging studies, a thorough physical exam, and a careful history of potential asbestos exposure.

FBLN3 is still considered to be a useful mesothelioma prognostic marker. Other biological markers for prognosis include the ratio of neutrophils to lymphocytes in the blood (a measure of how well the immune system is functioning), c-MET expression (associated with blood vessel formation for the tumor), and ki-67 ratios (associated with cancer cell proliferation).

Sources:

Battolla, E, et al, Comparison of the Diagnostic Performance of Fibulin-3 and Mesothelin in Patients with Pleural Effusions from Malignant Mesothelioma, March 2017, Anticancer Research, pp. 1387-131.

Creaney, J, et al, Comparison of mesothelin and fibulin-3 in pleural fluid and serum as markers in malignant mesothelioma, Mary 26, 2015, Current Opinions in Pulmonary Medicine, Epub ahead of print

Summary

Article Name

Diagnosing Pleural Mesothelioma with Lung Fluid: The Battle of the Biomarkers

Description

A biomarker called soluble mesothelin related peptide (SMRP) may be a more reliable way to diagnose malignant pleural mesothelioma from lung fluid than the protein fibulin-3.

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Alex Strauss

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Diagnosing Pleural Mesothelioma with Lung Fluid: The Battle of the Biomarkers - Surviving Mesothelioma