Circulating fibrinogen is a prognostic and predictive biomarker in malignant pleural mesothelioma

Abstract

Background:To investigate the clinical utility of pretreatment plasma fibrinogen levels in malignant pleural mesothelioma (MPM) patients.Methods:A retrospective multicenter study was performed in histologically proven MPM patients. All fibrinogen levels were measured at the time of diagnosis and clinical data were retrospectively collected after approval of the corresponding ethics committees.Results:In total, 176 MPM patients (mean age: 63.5 years±10.4 years, 38 females and 138 males) were analysed. Most patients (n=154, 87.5%) had elevated (⩾390 mg dl−1) plasma fibrinogen levels. When patients were grouped by median fibrinogen, patients with low level (⩽627 mg dl−1) had significantly longer overall survival (OS) (19.1 months, confidence interval (CI) 14.5–23.7 months) when compared with those with high level (OS 8.5; CI 6.2–10.7 months). In multivariate survival analyses, fibrinogen was found to be an independent prognostic factor (hazard ratio 1.81, CI 1.23–2.65). Most interestingly, fibrinogen (cutoff 75th percentile per 750 mg dl−1) proved to be a predictive biomarker indicating treatment benefit achieved by surgery within multimodality therapy (interaction term: P=0.034). Accordingly, only patients below the 75th percentile benefit from surgery within multimodality therapy (31.3 vs 5.3 months OS).Conclusions:Fibrinogen is a novel independent prognostic biomarker in MPM. Most importantly, fibrinogen predicted treatment benefit achieved by surgery within multimodality therapy.

Circulating activin A is a novel prognostic biomarker in malignant pleural mesothelioma – A multi-institutional study

“…Fibrinogen and circulating activin A levels demonstrated a similar prognostic power in the present study. Furthermore, a significant difference between the non-epithelioid and epithelioid subgroups was only found in activin A levels but not in fibrinogen concentrations [40].…”

“…We previously identified fibrinogen as a novel prognostic biomarker in MPM [40]. Thus, we performed a correlation analysis between fibrinogen and circulating activin A which revealed a significant relationship between these two parameters.…”

A Novel Prognostic Index in Patients with Resectable Esophageal Squamous Cell Carcinoma: Fibrinogen/Prealbumin Ratio

“…It has been reported that fibrinogen (Fib), a major protein in the blood clotting process, is associated with cancer 6 . Although recent studies have reported that plasma Fib was related to cancer progression and prognosis in various cancers [7][8][9] , the role of plasma Fib in EC remains controversial [10][11][12] . Recently, two metaanalyses revealed that plasma Fib was a prognostic indicator in patients with EC 13,14 .…”

A novel blood tool of cancer prognosis in esophageal squamous cell carcinoma: the Fibrinogen/Albumin Ratio

“…Fibrinogen, a glycoprotein synthesized by liver epithelium, plays an essential role in the coagulation cascade, converting to fibrin monomers and ultimately forming the fibrin polymers7. Previous studies indicated that elevated preoperative fibrinogen level might induce higher malignance progression and poor prognosis5,6. However, few studies have investigated the predictive impact of preoperative fibrinogen levels in ESCC patients.…”