The established and future biomarkers of malignant pleural mesothelioma

Asbestos-Related Research: First Objectivity then Conclusions

“…This is particularly true for mesothelioma, which did not have diagnostic category in the ICD system until the 10 th review was initiated in 1999 [18]. Histologically, malignant Mt can resemble various cancers and the lack of accurate biomarkers makes diagnosis challenging [19]. Some Mt studies may have mistakenly included tumors having similar morphology [17].…”

“…Cytogenetic studies found out that malignant Mt has complex and even chaotic chromosomal aberrations [14,22,23]. No marker discriminates well between Mt and other cancers [19,24], which, in conjunction with uncertainty about progenitor cells [14], makes the demarcation of Mt as an entity indistinct. Mesothelin and osteopontin have been considered promising markers, but both have limitations [18,25,26].…”

Biomarkers in malignant pleural mesothelioma: current status and future directions

“…MicroRNAs (miRNAs) are another group of markers being investigated as diagnostic and prognostic biomarkers owing to their tissue specificity and ability to classify several types of tumours (18). MicroRNAs are short non-coding RNAs (typically 19-25 nucleotides) that are involved in multiple cellular processes including development, proliferation and apoptosis.…”

“…In a subsequent study involving MPM patients undergoing EPP or P/D, a sixmiRNA signature including miR-21-5p, miR-23a-3p, miR30e-5p, miR-221-3p, miR-222-3p, and miR-31-5p was found to predict an overall survival of more than 20 months with an accuracy of 92.3% for EPP and 71.9% for P/D (19). Circulating miRNAs are also being investigated in MPM because of their stability in circulation (18), however larger studies are required to validate the diagnostic and prognostic values of miRNAs.…”

“…Although not covered in the review by Sun et al, it could be argued that predictive biomarkers are the most important as they have the potential to personalise treatments for MPM patients. The thymidylate synthase (TS) protein, encoded by the gene TYMS, is the main target for pemetrexed-based chemotherapy, however treatment responses do not appear to be strongly correlated with tumoural TS expression levels (18). So far, no predictive biomarkers have been recommended for clinical practice and none have been validated in independent and prospective studies.…”