Researchers have identified activin A, a protein complex in blood, as a potential target for future therapies.
"Biomarkers blood derivatives are important because they can be measured non-invasively, even at several stages," Dr. Balazs Hegedus, at the Medical University of Vienna in Austria, said Asbestos.com. "They can help make more personalized treatment decisions."
Besides Hegedus, Hungary cancer specialists, Switzerland and Australia participated in the study published in the latest issue of the European Journal of Cancer.
They measured levels of activin A 129 patients in four locations, 16 patients with benign pleural disease and 45 healthy people for comparison.
The researchers found significantly higher levels of activin A in mesothelioma patients and the tumor volume increased in direct correlation with the highest levels of the protein in circulation. They also found patients with lower levels of activin A at diagnosis lived significantly longer.Activin A Help histology
Patients with minor illnesses had only a slight increase in activin A, which also determined the histological classification of mesothelioma. Those sarcomatoid and biphasic mesothelioma - the two most difficult types to treat - had significantly higher levels of activin A as epithelioid.
Activin A is the first biomarker for mesothelioma to better identify histological differences. Other biomarkers, such as fibulin-3, are unable to distinguish.
Mesothelioma, a rare and aggressive cancer, is caused by the inhalation or ingestion of asbestos fibers. It is difficult to diagnose, and often metastasis before doctors can identify positively.
Earlier diagnosis, which is possible with a biomarker as activin A, it would be more manageable and give a better chance of survival. The majority of patients now live less than 15 months after diagnosis.Biomarker could personalize the treatment of mesothelioma
The most effective treatment approach is a multidisciplinary plan that includes a combination of surgery, chemotherapy and radiotherapy. It led to survival times of two or three years and beyond.
Too often, however, the aggressive treatment approach always leads to a decrease in quality of life without significantly extend survival time.
The problem: counselor accurately which patients would really make aggressive approach. This biomarker should make it easier for doctors to advise their patients.
"The multimodal treatment can be very demanding and should be offered to patients who can really benefit," said Balazs. "Any marker that can help identify patients whose prognosis is dismal or better can help with these decisions. "
Study results showed patients diagnosed with lower levels of activin A had a mean survival time of 735 days. Those who survived at higher levels on average 365 days, regardless of treatment decisions.
The prognostic benefit of activin A is more effective in patients aged under 66, according to the study. The authors also stated that the biomarker was more effective for those with epithelioid histology.
Although diagnostic and prognostic benefits can be immediate, therapeutic gains can take years. Previous preclinical in vitro studies have shown mesothelioma tumor cells use potentially activin A signaling to support growth, but further studies are needed to confirm how.
"If this becomes signaling [manageable] with targeted therapy, it could be of therapeutic value," Balazs said. "But we're not there yet."
