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Wednesday, October 10, 2012

The Need For New Blood and Effusion Biomarker for Pleural Mesothelioma

A report in the New England Journal of Medicine concludes that more research is urgently needed to detect biomarkers to detect pleural mesothelioma so that treatment option can be expanded. The only known cause of mesothelioma is asbestos exposure a medical condition that develops after a long latency period. Many individuals have been exposed to asbestos fiber at work, in the military and as bystanders.
Malignant Mesothelioma, coronal CT scan. Legen...
Malignant Mesothelioma, coronal CT scan. Legend: the malignant mesothelioma is indicated by yellow arrows, the central pleural effusion is marked with a yellow star. (1) right lung, (2) spine, (3) left lung, (4) ribs, (5) aorta, (6) spleen, (7) left kidney, (8) right kidney, (9) liver. (Photo credit: Wikipedia)

"Despite advances in chemotherapy, radiation therapy, and surgical management for malignant pleural mesothelioma, the median survival remains 12 months. Early detection is limited by the long latency period, an inability of imaging to detect the disease at an early stage even when it is used as a screening strategy, and the lack of sensitive and specific blood-based markers. Moreover, in patients with undiagnosed pleural effusion, the ability to diagnose mesothelioma is delayed by failure to include the disease in the differential diagnosis and by the lack of noninvasive mesothelioma-specific blood-based markers."

"Future investigations should also explore why fibulin-3 is selectively elevated in mesothelioma as compared with other cancers and should address the question of whether this is an epigenetic-based phenomenon either through methylation or microRNA control. These studies could potentially clarify the role of fibulin-3 in mesothelioma growth, invasion, and metastasis formation and determine whether the molecule might be targeted for specific cytotoxic or biologic therapies."

Fibulin-3 as a Blood and Effusion Biomarker for Pleural Mesothelioma
Harvey I. Pass, M.D., Stephen M. Levin, M.D., Michael R. Harbut, M.D., Jonathan Melamed, M.D., Luis Chiriboga, Ph.D., Jessica Donington, M.D., Margaret Huflejt, Ph.D., Michele Carbone, M.D., Ph.D., David Chia, Ph.D., Lee Goodglick, Ph.D., Gary E. Goodman, M.D., Mark D. Thornquist, Ph.D., Geoffrey Liu, M.D., Marc de Perrot, M.D., Ming-Sound Tsao, M.D., and Chandra Goparaju, Ph.D.
N Engl J Med 2012; 367:1417-1427October 11, 2012DOI: 10.1056/NEJMoa1115050
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