Whenever a patient is sick, doctors have to run a series of tests in order to determine what’s wrong. They’ll ask questions about the patient’s symptoms. Blood or tissue samples are collected for analysis. A series of radiological scans may reveal any abnormalities in a person’s bones or organ systems. For most diseases, one or a combination of any of these tests can help pinpoint the problem.
Unfortunately, a mesothelioma diagnosis isn’t one of those diseases. Individual cases of this asbestos-induced illness are complex, and not all patients share common markers of sickness.
However, this doesn’t make it any less important for scientists to continue developing new techniques to track changes in people’s mesothelioma. One team of scientists asserted that the patient population would benefit from research to find mesothelioma biomarkers, and discussed the obstacles to that goal in the Journal of Thoracic Disease.
Why are biomarkers hard to find?
Experts from the Environmental Working Group estimated that, every year, more than 2,500 individuals in the U.S. die from mesothelioma. That figure jumps to more than 9,900 when encompassing all diseases that are attributable to asbestos exposure. Furthermore, these numbers won’t hit their peak in the U.S., U.K. and Australia for another 10 years or so.
This underscores the importance of finding mesothelioma biomarkers. Authors of the new paper defined the ideal biomarker as an indicator of disease that increases when the sickness is present, doesn’t increase if the illness isn’t present, is related to disease burden and evolves as a response to changes in a patient’s condition.
Usually, biomarkers can be helpful in the diagnostic stages, but diagnostic mesothelioma biomarkers can be difficult to find, according to the study authors. This is because there can be many differences among individual patients that make it hard to find a common genetic signature or protein expression profile within the population.
Additionally, once scientists find candidates for mesothelioma biomarkers, they have to conduct clinical trials that include a large number of patients in order to find out whether those mesothelioma biomarkers are valid. However, when it comes to asbestos-induced diseases, the number of patients needed to evaluate a biomarker candidate often falls short. Also, there are several types of mesothelioma, and clinical researchers may be biased when selecting which patients’ disease types to enroll for their studies.
Prognostic mesothelioma biomarkers may be more feasible
Although scientists are having a lot of difficulty finding biomarkers that can help them diagnose mesothelioma, they may have an easier time pinpointing the mesothelioma biomarkers that track patients’ progress. This type of biomarker is valuable because it can help doctors make decisions about which treatments are worth trying and continuing in patients.
One promising approach is to look at the family of proteins known as mesothelin, which is measurable through blood tests. According to the American Cancer Society, osteopontin is another protein in the blood that may become useful as a biomarker that monitors patients’ progress.
“More potential biomarkers are being identified, on a regular basis,” the researchers wrote. “For these targets to attain their professed clinical potential, independent externally validated studies with large, representative patient cohorts will be required. A combination of potential biomarkers should also be evaluated. The next stage will need studies to determine how to integrate promising markers into clinical diagnostic and/or management algorithms, a process essential in the evaluation of markers.”
As countries like China and India continue to consume asbestos, and the U.S. refuses to eliminate asbestos use, the availability of better mesothelioma biomarkers becomes more essential.