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Updated: Apr 12, 2026
Generation and Expansion of Primary, Malignant Pleural Mesothelioma Tumor Lines
Published on: April 21, 2022
The established and future biomarkers of malignant pleural mesothelioma
V Panou1, M Vyberg2, U M Weinreich3
1Department of Respiratory Medicine, Aalborg University Hospital, Aalborg, Denmark; Department of Oncology & Clinical Cancer Research Center, Aalborg University Hospital, DK-9000 Aalborg, Denmark.
Abstract:
Malignant pleural mesothelioma (MPM) is an asbestos-related cancer with a median survival of 12months. The MPM incidence is 1-6/100,000 and is increasing as a result of historic asbestos exposure in industrialized countries and continued use of asbestos in developing countries. Lack of accurate biomarkers makes diagnosis, prognostication and treatment prediction of MPM challenging. The aim of this review is to identify the front line of MPM biomarkers with current or potential clinical impact. Literature search using the PubMed and PLoS One databases, the related-articles function of PubMed and the reference lists of associated publications until April 26th 2015 revealed a plethora of candidate biomarkers. The current gold standard of MPM diagnosis is a combination of two positive and two negative immunohistochemical markers in the epithelioid and biphasic type, but sarcomatous type do not have specific markers, making diagnosis more difficult. Mesothelin in serum and pleural fluid may serve as adjuvant diagnostic with high specificity but low sensitivity. Circulating proteomic and microRNA signatures, fibulin-3, tumor cell gene-ratio test, transcriptomic, lncRNA, glycopeptides, pleural fluid FISH assay, hyaluronate/N-ERC mesothelin and deformability cytometry may be important future markers. Putative predictive markers for pemetrexed-platinum are tumor TS and TYMS, for vinorelbine the ERCC1, beta-tubuline class III and BRCA1. Mutations of the BAP1 gene are potential markers of MPM susceptibility. In conclusion, the current status of MPM biomarkers is not satisfactory but encouraging as more sensitive and specific non-invasive markers are emerging. However, prospective validation is needed before clinical application.
Insights
Malignant pleural mesothelioma (MPM) diagnosis lacks accurate biomarkers. While current methods are insufficient, emerging non-invasive markers show promise for improved clinical application in this asbestos-related cancer.
Area of Science:
- Oncology
- Biomarker Discovery
- Asbestos-Related Diseases
Background:
- Malignant pleural mesothelioma (MPM) is an aggressive asbestos-related cancer with poor prognosis.
- Current diagnostic and prognostic tools for MPM are limited, particularly for sarcomatous types.
- The incidence of MPM is increasing globally due to historical and ongoing asbestos exposure.
Purpose of the Study:
- To review current and potential biomarkers for malignant pleural mesothelioma (MPM).
- To assess the clinical impact of identified MPM biomarkers for diagnosis, prognostication, and treatment prediction.
- To highlight the need for further validation of promising MPM biomarkers.
Main Methods:
- Comprehensive literature search of PubMed and PLoS One databases.
- Inclusion of related articles and reference lists up to April 26th, 2015.
- Analysis of immunohistochemical markers, serum/pleural fluid markers, proteomic and microRNA signatures, and genetic mutations.
Main Results:
- Current MPM diagnosis relies on immunohistochemistry, with limitations for specific subtypes.
- Mesothelin shows potential as an adjuvant diagnostic marker but with low sensitivity.
- Numerous candidate biomarkers including circulating signatures, fibulin-3, and gene-based tests are emerging, with some showing predictive potential for chemotherapy.
Conclusions:
- The current landscape of MPM biomarkers is inadequate but evolving.
- Emerging non-invasive biomarkers offer encouraging prospects for improved clinical utility.
- Prospective validation studies are crucial before widespread clinical adoption of new MPM biomarkers.
