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Updated: May 3, 2026
Generation and Expansion of Primary, Malignant Pleural Mesothelioma Tumor Lines
Published on: April 21, 2022
Circulating fibrinogen is a prognostic and predictive biomarker in malignant pleural mesothelioma
B Ghanim1, M A Hoda1, T Klikovits2
11] Division of Thoracic Surgery, Department of Surgery, Medical University of Vienna 1090, Vienna, Austria [2] Institute of Cancer Research, Department of Internal Medicine I, Medical University of Vienna 1090, Vienna, Austria.
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.
Insights
Elevated plasma fibrinogen levels indicate a poor prognosis in malignant pleural mesothelioma (MPM) patients. Fibrinogen also predicts who benefits from surgery as part of multimodality therapy.
Area of Science:
- Oncology
- Biomarkers
- Thoracic Surgery
Background:
- Malignant pleural mesothelioma (MPM) is a rare and aggressive cancer.
- Identifying prognostic and predictive biomarkers is crucial for optimizing patient management.
Purpose of the Study:
- To evaluate the clinical utility of pretreatment plasma fibrinogen levels in MPM patients.
- To determine if fibrinogen can serve as a prognostic and predictive biomarker.
Main Methods:
- Retrospective multicenter study of 176 histologically confirmed MPM patients.
- Plasma fibrinogen levels measured at diagnosis; clinical data collected retrospectively.
- Multivariate survival analyses performed to assess prognostic significance.
Main Results:
- Most MPM patients (87.5%) presented with elevated fibrinogen (≥ 390 mg/dL).
- Lower fibrinogen levels correlated with significantly longer overall survival (OS) (19.1 vs. 8.5 months).
- Fibrinogen independently predicted prognosis (HR 1.81) and identified patients benefiting from surgery within multimodality therapy (P=0.034).
Conclusions:
- Plasma fibrinogen is a novel, independent prognostic biomarker in MPM.
- Fibrinogen predicts treatment benefit from surgery in multimodality therapy for MPM patients.
