Clapper, Patti, Schweizer and Mason

Malignant mesothelioma can occur in the pleura (lining of the lungs), pericardium (lining of the heart) or peritonea (lining of the abdomen).  Pleural mesothelioma is the most common, is very aggressive, and resistant to conventional cancer treatments.   Researchers have been conducting clinical trials to try to further their ability to diagnose, manage and treat the disease.

Two recent clinical trials describe recent advances in identifying and treating mesothelioma.  One study conducted at Princess Margaret Hospital in Canada further clarified the use of soluble mesothelin-related peptide (MSRP) as a distinguishing marker of mesothelioma versus benign pleural disease.  The other study from the Vanderbilt School of Medicine in Tennessee examined the role of how microRNA (miRNA) genes are linked with progression of mesothelioma.

The Canada researchers were evaluating whether SMRP and osteopontin (OP) could be used as markers of response and disease course in mesothelioma.  Initial results showed that all patients with malignant disease progression had elevated SMRP levels, whereas there were no changes in OP levels.  They therefore deduce that further research into SMRP in clinical trials and practice is warranted and should be pursued.

The Tennessee clinical trial investigated the link between progression of mesothelioma and abnormal expression of miRNA genes.  MiRNAs regulate gene expression and play a central role in the development and expression of mesothelioma as well as other cancers.  The study confirmed the potential for miRNA expression to differentiate between mesothelioma and other benign tumors in the pleura, an often difficult thing to do but one very helpful in the diagnostic and management process.  The use of miRNAs is called microarray profiling, an area of research that is helping scientists to find new ways to intervene earlier in diagnosing mesothelioma and slowing progression of the disease.

As more clinical trials are conducted, new diagnostic and prognostic markers as well as treatments for mesothelioma are being discovered, giving hope that with each study more options will become available that increase survival times and improve quality of life.