Biomarkers for early diagnosis of malignant mesothelioma: Do we need another moonshot?

Abstract

Early diagnosis of malignant pleural mesothelioma (MPM) is a challenge for clinicians. The disease is usually detected in an advanced stage which precludes curative treatment. We assume that only new and non-invasive biomarkers allowing earlier detection will result in better patient management and outcome. Many efforts have already been made to find suitable biomarkers in blood and pleural effusions, but have not yet resulted in a valid and reproducible diagnostic one. In this review, we will highlight the strengths and shortcomings of blood and fluid based biomarkers and highlight the potential of breath analysis as a non-invasive screening tool for MPM. This method seems very promising in the early detection of diverse malignancies, because exhaled breath contains valuable information on cell and tissue metabolism. Research that focuses on breath biomarkers in MPM is in its early days, but the few studies that have been performed show promising results. We believe a breathomics-based biomarker approach should be further explored to improve the follow-up and management of asbestos exposed individuals.

Measurement of telomere length in cells from pleural effusion: Asbestos exposure causes telomere shortening in pleural mesothelial cells

“…Moreover, MM is a malignant tumor for which early diagnosis is particularly difficult. 24 Our present findings suggest that telomere shortening in the mesothelial cells of pleural effusion could predict the risk of MM development. If telomere length of such cells could be measured periodically, it might be possible to evaluate the risk of MM development and be helpful for early detection and treatment of MM.…”

“…The latency period of asbestos‐related MM is very long, and therefore it is very difficult or impossible to predict whether a person who has a history of asbestos exposure will develop MM in future. Moreover, MM is a malignant tumor for which early diagnosis is particularly difficult . Our present findings suggest that telomere shortening in the mesothelial cells of pleural effusion could predict the risk of MM development.…”

Mutational Profiling of Driver Tumor Suppressor and Oncogenic Genes in Brazilian Malignant Pleural Mesotheliomas

“…MPM is a direct causal relationship between exposure to an environmental carcinogen, such as asbestos, and the transformation of mesothelial cells and the development of the tumor [2]. Asbestos is a generic name referring to a family of 6 mineral fibers, with high tensile strength and resistance to thermal and chemical degradation, very popular in the industry [1, 8]. Although the use of asbestos has already been prohibited in 54 countries worldwide, its extraction and use are still ongoing in many developing countries as Russia, China, Kazakhstan, and Brazil [2, 9].…”

The electronic nose: emerging biomarkers in lung cancer diagnostics

“…The first tests were published in 2012 [30,31], showing that molecular pattern recognition of exhaled breath could distinguish mesothelioma patients from healthy controls. More recently, this was confirmed by a study combining breath analysis by gas chromatography-mass spectrometry and an e-nose [32,33].…”