Kinetics of Soluble Mesothelin in Patients with Malignant Pleural Mesothelioma during Treatment

• Published in: American journal of respiratory and critical care medicine Vol. 179; no. 10; pp. 950 - 954
• Main Authors: Grigoriu, Bogdan D, Chahine, Bachar, Vachani, Anil, Gey, Thomas, Conti, Massimo, Sterman, Daniel H, Marchandise, Genevieve, Porte, Henri, Albelda, Steven M, Scherpereel, Arnaud
• Format: Journal Article
• Language: English
• Published: New York, NY Am Thoracic Soc 15-05-2009; American Thoracic Society
• Subjects: Aged; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Biomarkers, Tumor - blood; Clinical death. Palliative care. Organ gift and preservation; Enzyme-Linked Immunosorbent Assay; Epithelial Cells - pathology; Female; Genetic Therapy - methods; Humans; Intensive care medicine; Interferon-beta - biosynthesis; Interferon-beta - genetics; Male; Medical sciences; Mesothelioma - blood; Mesothelioma - genetics; Mesothelioma - therapy; Middle Aged; Pleural Neoplasms - blood; Pleural Neoplasms - genetics; Pleural Neoplasms - therapy; Prognosis; Treatment Outcome; Human; Intensive care; Prognosis; Respiratory disease; Malignant tumor; Treatment; marker; Pleural disease; neoplasm; Malignant pleural mesothelioma; Pleura; Resuscitation; Cancer
• ISSN: 1073-449X; 1535-4970
• DOI: 10.1164/rccm.200807-1125OC

Previous data suggested that serum levels of soluble mesothelin (SM) are related to tumor size and may have prognostic significance in malignant pleural mesothelioma (MPM).
We tested the hypothesis that this marker could also be useful for monitoring response to treatment.
Serial measurements of SM were determined in 40 patients diagnosed with MPM and subjected to gene-transfer therapy using intrapleural infusion of an adenoviral vector expressing human IFN-beta or conventional treatment (mainly chemotherapy).
In patients with baseline SM levels greater than 1 nM/L and disease progression after therapy, SM levels increased by 2.1 nM/L at two, 5.2 nM/L at four and 1.3 nM/L at 6 months. Patients with initial SM below 1 nM/L had a similar but more moderate increase of SM over time. Patients who responded to treatment or were considered stable had an initial small decrease of SM followed by a return to baseline values after 6 months of follow-up. In patients with baseline SM levels greater than 1 nM/L, increasing levels were associated with a significantly shorter median survival than in patients with stable or decreasing SM levels (4.4 vs. 27.7 months; P = 0.012).
Increasing serum levels of SM were associated with disease progression and worse outcome, whereas stable or decreasing values suggested response to treatment. If confirmed in larger series, SM could be used to monitor patients with malignant pleural mesothelioma under treatment.