Fibulin-3 as a biomarker of response to treatment in malignant mesothelioma

Abstract

Objectives: Fibulin-3 is a new potential biomarker for malignant mesothelioma (MM). This study evaluated the potential applicability of fibulin-3 plasma levels as a biomarker of response to treatment and its prognostic value for progressive disease after the response to treatment in MM. The potential applicability of fibulin-3 in comparison with or in addition to soluble mesothelin-related peptides (SMRP) was also assessed.

Materials and Methods: The study included 78 MM patients treated at the Institute of Oncology Ljubljana between 2007 and 2011. Fibulin-3 levels in plasma samples obtained before treatment and in various responses to treatment were measured with the enzyme-linked immunosorbent assay.

Results: In patients evaluated before the treatment, fibulin-3 levels were not influenced by histopathological subtypes, tumor stages or the presence of metastatic disease. Significantly higher fibulin-3 levels were found in progressive disease as compared to the levels before treatment (U = 472.50, p = 0.003), in complete response to treatment (U = 42.00, p = 0.010), and in stable disease (U = 542.00, p = 0.001). Patients with fibulin-3 levels exceeding 34.25 ng/ml before treatment had more than four times higher probability for developing progressive disease (OR = 4.35, 95% CI 1.56–12.13). Additionally, patients with fibulin-3 levels above 34.25 ng/ml in complete response to treatment and in stable disease had increased odds for progressive disease within 18 months (OR = 6.94, 95% CI 0.99–48.55 and OR = 4.39, 95% CI 1.63–11.81 respectively).

Conclusions: Our findings suggest that in addition to SMRP fibulin-3 could also be helpful in detecting the progression of MM.