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Osteopontin Shows Promise as Marker for Detecting Pleural Mesothelioma
Pleural Mesothelioma Diagnostic Study Found:
October 21, 2005 — According to a new study, measuring the amount of osteopontin in the blood may help detect the presence of pleural mesothelioma, an asbestos–related cancer that first attacks the membranes lining the lungs and chest (N Engl J Med, 2005 Oct 13; 353(15):1564–73). Osteopontin is a protein that affects cell interactions and cell signaling. It is associated with tumor invasion and spread. High osteopontin levels have been found in patients with cancers of the lung, breast and colon.
The researchers looked at the osteopontin levels in the tissue and blood samples of three groups:
- » 69 patients with asbestos–related lung illnesses such as asbestosis that were not cancerous.
- » 45 people who were never exposed to asbestos.
- » 76 patients with pleural mesothelioma who were exposed to asbestos. The extent of mesothelioma was determined by surgical techniques (surgical staging) and CT chest scans.
The osteopontin levels of the pleural mesothelioma patients were more than four times higher than the levels in patients with non–cancerous asbestos diseases (133 ng/ml compared to 30 ng/ml). The osteopontin levels identified nearly 78% of pleural mesothelioma cases, including stage I or early mesothelioma as well as advanced mesothelioma. Osteopontin levels were not much greater in patients with non–cancerous asbestos diseases compared to individuals who had never been exposed to asbestos.
Identifying Early Stage Pleural Mesothelioma
Osteopontin blood levels provide a useful marker for pleural mesothelioma, the researchers concluded. Blood tests could provide a simple way to monitor workers who are at high risk for asbestos exposure such as miners, carpenters, electricians, boilermakers, railroad employees, insulators, and plumbers.
The most important result of the study was that osteopontin levels could identify pleural mesothelioma in its early stages when it may respond best to surgery. Patients with stage I or early mesothelioma who undergo surgery may have their lives prolonged by as much as five years, according to the researchers. If surgery is performed during the later stages of pleural mesothelioma, however, the advantage may be only a few months.
One surgical technique, extrapleural pneumonectomy, removes portions of the lung, the lining of the lung and the lining of the heart. Although it has some success in removing mesothelioma tumor cells, an extrapleural pneumonectomy is not usually performed on an advanced mesothelioma patient because he or she may not be able to withstand its rigors. Patients with advanced pleural mesothelioma may opt to take the chemotherapy drug ALIMTA®, which is used in combination with another chemotherapy drug, cisplatin, to treat mesothelioma that cannot respond well to surgery.
Pleural Mesothelioma Diagnosis and Mesomark™
Osteopontin analysis is not the only type of blood test proposed for diagnosing pleural mesothelioma. Earlier this year, Mesomark™ was approved in Europe, New Zealand, and Australia. Mesomark™ measures the blood serum concentrations of a marker called soluble mesothelin–related protein (SMRP). SMRP levels are higher in patients with mesothelioma than they are in people without the disease. Fujirebio Diagnostics, the manufacturer of Mesomark™, has filed an application with the Food and Drug Administration (FDA) to market the test in the United States. The FDA has not yet acted upon the application. (See New Mesothelioma Blood Test.)
For further details about mesothelioma diagnosis, see Pleural Mesothelioma Diagnosis Can Be Complex. The section discusses imaging, PET, sampling, and tumor staging. If you or a loved one has been diagnosed with pleural mesothelioma, please feel free to contact us to learn about your legal choices. We have been handling cases involving mesothelioma and asbestos exposure for over 20 years and can provide support, information, and excellent advocacy.
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