The search to uncover easier and earlier ways to diagnose mesothelioma took a step in the right direction with the latest findings from the laboratory of New York University Langone Medical Center and renowned thoracic oncologist Harvey Pass, M.D.
Researchers there have found that fibulin-3 – a new protein biomarker found in blood – can reliably predict the presence, or absence, of mesothelioma cancer cells. This finding could open the way for a long sought-after screening tool for anyone exposed to asbestos.
"There is reason to be encouraged," Pass said in recent interview with Asbestos.com. "Stay tuned. There is a real interest in this research because the real gain will be made by finding it (mesothelioma) earlier, when the treatments can be more effective."
The findings were published this month in the New England Journal of Medicine. Pass was joined in the study by high-profile colleagues Michele Carbone, M.D., the University of Hawaii Cancer Center; Michael Harbut, M.D., Wayne State University; and Anne Tsao, M.D., the MD Anderson Cancer Center in Houston.
Mesothelioma is a rare cancer caused by asbestos exposure. It is diagnosed in an estimated 3,000 Americans each year, leaving many with a grim prognosis. By the time mesothelioma usually is diagnosed, surgery often is not an option because the cancer already has spread throughout the body.
The medical community in the past has struggled in its search for a reliable screening tool. Because mesothelioma symptoms often can mirror those of less serious illnesses, an accurate diagnosis can be a six-month process.
This latest discovery could be a significant breakthrough, allowing doctors to accelerate the process and possibly monitor the presence of fibulin-3 in people with a history of major exposure to asbestos.
"It's a first step, but a very promising step," Pass told Reuters Health. "We're enthused that this marker eventually will help the mesothelioma community."
This study had a 96.7 percent success rate in accurately determining the presence or absence of mesothelioma when looking at blood and pleural fluid of patients.
The study included the measuring of fibulin-3 levels in 92 people with mesothelioma, 136 cancer-free patients with previous asbestos exposure, 93 with pleural effusions unrelated to mesothelioma, and 43 health controls.
Pass believes the next step toward advancement will be monitoring a larger group of high-risk patients to see if their fibulin-3 levels begin to elevate and reflect early stage mesothelioma.
"The problem now is that patients present with late-stage, bulky disease where we have very few options," Pass told Reuters Health. "With an earlier presentation, you have a surgical option and better treatment results, and they have better responses to chemotherapy. You can convert this to a disease that you can chronically treat."
The best treatment results currently have come from a multimodal approach that includes surgery, chemotherapy and radiation. With that approach, early stage patients often can live more than two years, and a few from five to 10 years after the initial diagnosis.
Scientists have been looking at various biomarkers for several years, but none have been as reliable as fibulin-3 was in this latest report. The protein mesothelin often has been cited as a biomarker for mesothelioma, but it has not shown the sensitivity to testing that fibulin-3 has. It is considered unreliable for early stage testing.
Earlier this year, Pass received the Pioneer Award from the Mesothelioma Applied Research Foundation for his research work. His latest findings are expected to be greeted enthusiastically in the mesothelioma community.
