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Dr. Pass has found that the level of fibulin-3 protein in plasma can be used to distinguish healthy persons with exposure to asbestos from patients with mesothelioma.
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Background and Description of Technology: Malignant pleural mesothelioma is an asbestos-related disease with 2000 to 3000 new cases diagnosed annually in the United States alone. With patients often initially seeking treatment at a symptomatic late stage, the majority of cases at the time of diagnosis are surgically unresectable due to extensive local disease, contributing to median survival at a mere 6-8 months. For those who do undergo aggressive surgical reduction of the tumor, the majority of patients suffer local relapse despite aggressive adjuvant/neoadjuvant therapy. Despite the need for early diagnosis, there is a lack of noninvasive mesothelioma-specific blood-based markers. Soluble mesothelin-related protein, the most extensively blood-based mesothelioma biomarker, is limited by overall sensitivity. Recent attempts to utilize serum osteopontin have likewise been plagued by reproducibility issues. Dr. Pass has found that the level of fibulin-3 protein in plasma can be used to distinguish healthy persons with exposure to asbestos from patients with mesothelioma. When analyzed in conjunction with the level of fibulin-3 found in a pleural effusion (an abnormal buildup of fluid between the lungs and chest cavity) plasma fibulin-3 levels can further be utilized to differentiate mesothelioma-related effusions from effusions stemming from other malignant and benign conditions. Notably, fibulin-3 levels are rather stable and do not vary according to age, sex, or duration of asbestos exposure. Applications: This method represents a novel strategy for the differential diagnosis of patients with malignant mesothelioma versus those that are healthy, have a history of asbestos exposure, or present with pleural effusion due to a host of other malignant or benign conditions. The discovery of the present invention has tremendous translational implications to improving the speed and accuracy of diagnosis for patients with a history of asbestos exposure and/or suffering from the symptoms of malignant mesothelioma. Furthermore, this method may aid in determining relapse following surgical reduction of the tumor and adjuvant treatment.