A prospective study to investigate the role of serial serum mesothelin in monitoring mesothelioma
Abstract Background Radiological monitoring of malignant pleural mesothelioma (MPM) using modified RECIST criteria is limited by low sensitivity and inter-observer variability. Serial serum mesothelin measurement has shown utility in the assessment of treatment response during chemotherapy but has n...
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2018-02-01
|
| Series: | BMC Cancer |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12885-018-4113-3 |
| _version_ | 1819073105374478336 |
|---|---|
| author | Duneesha de Fonseka David T. Arnold Louise Stadon Anna Morley Emma Keenan Michael Darby Lynne Armstrong Paul Virgo Nick A. Maskell |
| author_facet | Duneesha de Fonseka David T. Arnold Louise Stadon Anna Morley Emma Keenan Michael Darby Lynne Armstrong Paul Virgo Nick A. Maskell |
| author_sort | Duneesha de Fonseka |
| collection | DOAJ |
| description | Abstract Background Radiological monitoring of malignant pleural mesothelioma (MPM) using modified RECIST criteria is limited by low sensitivity and inter-observer variability. Serial serum mesothelin measurement has shown utility in the assessment of treatment response during chemotherapy but has never been assessed in the longer term follow up of patients. Methods This is a single centre study of consecutive patients diagnosed with MPM who received chemotherapy or best supportive care (BSC). Serum mesothelin measurements with paired 6 monthly CT scans were performed following the completion of chemotherapy, or from baseline in the BSC group. Changes in mesothelin were correlated with radiological progression and overall survival. Results Forty-one patients with MPM were recruited and followed up for a minimum of 12 months (range 12–21 months). The majority of patients (n = 23) received chemotherapy with pemetrexed and cisplatin. Across the cohort a 10% rise in serum mesothelin could predict radiological progression with a sensitivity of 96% (IQR; 79–100) and specificity of 74% (IQR; 50–91). Sensitivity fell to 80% in sarcomatoid only disease. Patients with a rising mesothelin at 6 months had significantly worse overall survival (175 days) compared to stable/falling levels (448 days) (p = 0.003). Conclusions This is the first study to assess serum mesothelin’s ability to detect progression of MPM following chemotherapy or during BSC. A 10% rise in serum mesothelin level showed excellent sensitivity at predicting progressive disease. Mesothelin measurement has several advantages over serial CT imaging including reducing hospital visits and cost. |
| first_indexed | 2024-12-21T17:48:20Z |
| format | Article |
| id | doaj.art-e378b07bcb54478c9e1a9981b2e2183d |
| institution | Directory Open Access Journal |
| issn | 1471-2407 |
| language | English |
| last_indexed | 2024-12-21T17:48:20Z |
| publishDate | 2018-02-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cancer |
| spelling | doaj.art-e378b07bcb54478c9e1a9981b2e2183d2022-12-21T18:55:26ZengBMCBMC Cancer1471-24072018-02-011811710.1186/s12885-018-4113-3A prospective study to investigate the role of serial serum mesothelin in monitoring mesotheliomaDuneesha de Fonseka0David T. Arnold1Louise Stadon2Anna Morley3Emma Keenan4Michael Darby5Lynne Armstrong6Paul Virgo7Nick A. Maskell8Academic Respiratory Unit, School of Clinical Sciences, University of Bristol, Learning and Research Centre, Southmead Hospital, Westbury-on-TrymAcademic Respiratory Unit, School of Clinical Sciences, University of Bristol, Learning and Research Centre, Southmead Hospital, Westbury-on-TrymAcademic Respiratory Unit, School of Clinical Sciences, University of Bristol, Learning and Research Centre, Southmead Hospital, Westbury-on-TrymAcademic Respiratory Unit, School of Clinical Sciences, University of Bristol, Learning and Research Centre, Southmead Hospital, Westbury-on-TrymAcademic Respiratory Unit, School of Clinical Sciences, University of Bristol, Learning and Research Centre, Southmead Hospital, Westbury-on-TrymDepartment of Radiology, Southmead Hospital, North Bristol NHS TrustDepartment of Radiology, University Hospitals BristolAcademic Respiratory Unit, School of Clinical Sciences, University of Bristol, Learning and Research Centre, Southmead Hospital, Westbury-on-TrymAcademic Respiratory Unit, School of Clinical Sciences, University of Bristol, Learning and Research Centre, Southmead Hospital, Westbury-on-TrymAbstract Background Radiological monitoring of malignant pleural mesothelioma (MPM) using modified RECIST criteria is limited by low sensitivity and inter-observer variability. Serial serum mesothelin measurement has shown utility in the assessment of treatment response during chemotherapy but has never been assessed in the longer term follow up of patients. Methods This is a single centre study of consecutive patients diagnosed with MPM who received chemotherapy or best supportive care (BSC). Serum mesothelin measurements with paired 6 monthly CT scans were performed following the completion of chemotherapy, or from baseline in the BSC group. Changes in mesothelin were correlated with radiological progression and overall survival. Results Forty-one patients with MPM were recruited and followed up for a minimum of 12 months (range 12–21 months). The majority of patients (n = 23) received chemotherapy with pemetrexed and cisplatin. Across the cohort a 10% rise in serum mesothelin could predict radiological progression with a sensitivity of 96% (IQR; 79–100) and specificity of 74% (IQR; 50–91). Sensitivity fell to 80% in sarcomatoid only disease. Patients with a rising mesothelin at 6 months had significantly worse overall survival (175 days) compared to stable/falling levels (448 days) (p = 0.003). Conclusions This is the first study to assess serum mesothelin’s ability to detect progression of MPM following chemotherapy or during BSC. A 10% rise in serum mesothelin level showed excellent sensitivity at predicting progressive disease. Mesothelin measurement has several advantages over serial CT imaging including reducing hospital visits and cost.http://link.springer.com/article/10.1186/s12885-018-4113-3MesotheliomaMesothelinBiomarkersMonitoring |
| spellingShingle | Duneesha de Fonseka David T. Arnold Louise Stadon Anna Morley Emma Keenan Michael Darby Lynne Armstrong Paul Virgo Nick A. Maskell A prospective study to investigate the role of serial serum mesothelin in monitoring mesothelioma BMC Cancer Mesothelioma Mesothelin Biomarkers Monitoring |
| title | A prospective study to investigate the role of serial serum mesothelin in monitoring mesothelioma |
| title_full | A prospective study to investigate the role of serial serum mesothelin in monitoring mesothelioma |
| title_fullStr | A prospective study to investigate the role of serial serum mesothelin in monitoring mesothelioma |
| title_full_unstemmed | A prospective study to investigate the role of serial serum mesothelin in monitoring mesothelioma |
| title_short | A prospective study to investigate the role of serial serum mesothelin in monitoring mesothelioma |
| title_sort | prospective study to investigate the role of serial serum mesothelin in monitoring mesothelioma |
| topic | Mesothelioma Mesothelin Biomarkers Monitoring |
| url | http://link.springer.com/article/10.1186/s12885-018-4113-3 |
| work_keys_str_mv | AT duneeshadefonseka aprospectivestudytoinvestigatetheroleofserialserummesothelininmonitoringmesothelioma AT davidtarnold aprospectivestudytoinvestigatetheroleofserialserummesothelininmonitoringmesothelioma AT louisestadon aprospectivestudytoinvestigatetheroleofserialserummesothelininmonitoringmesothelioma AT annamorley aprospectivestudytoinvestigatetheroleofserialserummesothelininmonitoringmesothelioma AT emmakeenan aprospectivestudytoinvestigatetheroleofserialserummesothelininmonitoringmesothelioma AT michaeldarby aprospectivestudytoinvestigatetheroleofserialserummesothelininmonitoringmesothelioma AT lynnearmstrong aprospectivestudytoinvestigatetheroleofserialserummesothelininmonitoringmesothelioma AT paulvirgo aprospectivestudytoinvestigatetheroleofserialserummesothelininmonitoringmesothelioma AT nickamaskell aprospectivestudytoinvestigatetheroleofserialserummesothelininmonitoringmesothelioma AT duneeshadefonseka prospectivestudytoinvestigatetheroleofserialserummesothelininmonitoringmesothelioma AT davidtarnold prospectivestudytoinvestigatetheroleofserialserummesothelininmonitoringmesothelioma AT louisestadon prospectivestudytoinvestigatetheroleofserialserummesothelininmonitoringmesothelioma AT annamorley prospectivestudytoinvestigatetheroleofserialserummesothelininmonitoringmesothelioma AT emmakeenan prospectivestudytoinvestigatetheroleofserialserummesothelininmonitoringmesothelioma AT michaeldarby prospectivestudytoinvestigatetheroleofserialserummesothelininmonitoringmesothelioma AT lynnearmstrong prospectivestudytoinvestigatetheroleofserialserummesothelininmonitoringmesothelioma AT paulvirgo prospectivestudytoinvestigatetheroleofserialserummesothelininmonitoringmesothelioma AT nickamaskell prospectivestudytoinvestigatetheroleofserialserummesothelininmonitoringmesothelioma |