um Mesothelin for Early Detection of Asbestos - Induced B & P cer Malignant Mesothelioma

ownload kground: Malignant mesothelioma is an aggressive, almost uniformly fatal tumor, primarily caused by re to asbestos. Since the recent discovery that serum mesothelin is a sensitive and highly specific bior for mesothelioma, one of the key issues raised is whether mesothelin levels represent a useful screening r asbestos-exposed at-risk individuals. In this study, soluble mesothelin was determined in sequential samples collected from asbestos-exposed individuals before the development of mesothelioma. thods: Archival serum samples from 106 individuals who developed mesothelioma, 99 asbestosd individuals from the Wittenoom Cancer Surveillance Program, and 109 non–asbestos-exposed indils from the Busselton Health Survey were identified. Serum mesothelin concentrations were determined the MESOMARK assay. ults: Longitudinal mesothelin levels determined in healthy asbestos-exposed individuals over a period ears were stable (Pearson's r = 0.96; P < 0.0001). There was no correlation between mesothelin contion and cumulative asbestos exposure. Mesothelin concentrations were greater than the threshold of 2.5 nmol/L in the penultimate serum sample before the diagnosis of mesothelioma in 17 of 106 . Using an increase above the 95% confidence interval of the mean of a given individual's longitudinal helin results, 33 of 82 individuals had increasing mesothelin levels before diagnosis. clusion: In a population with a high pretest probability of developing mesothelioma, the serum rker mesothelin is elevated in absolute terms in 15% and in relative terms in 40% of the group. bioma Impact: Future studies examining a combination of biomarkers could improve sensitivity of screening. Cancer Epidemiol Biomarkers Prev; 19(9); 2238–46. ©2010 AACR.