title: Soluble mesothelin-related Peptide and osteopontin as markers of response in malignant mesothelioma.
abstract: OBJECTIVE
  In malignant mesothelioma (MM), radiologic assessment of disease status is difficult. Both soluble mesothelin-related peptide (SMRP) and osteopontin (OP) have utility in distinguishing MM from benign pleural disease. We evaluated whether SMRP and OP also correlated with the disease course of MM.
  
  
  METHODS
  Serial plasma samples from patients with MM were prospectively collected, and SMRP and OP levels were measured. Radiologic tests across time periods showing disease progression, stability, or shrinkage were compared with corresponding changes in SMRP/OP levels.
  
  
  RESULTS
  From 41 patients, 165 samples were collected (range, 2 to 10; median 4). At study entry, 37 of 41 patients had measurable disease, of whom 92% (34 of 37) had elevated baseline SMRP levels; four of 41 patients had no evidence of recurrence and each had normal baseline SMRP levels. In 21 patients receiving systemic therapy, percentage change in SMRP more than 10% correlated with the radiologic assessment by a trained thoracic radiologist (P < .001), by formal Response Evaluation Criteria in Solid Tumors (RECIST; P = .008), or by modified RECIST (P < .001). All seven patients who underwent surgical resection with negative margins had elevated preoperative SMRP levels that fell to normal postoperatively. Rising SMRP was observed in all patients with radiologic disease progression. No associations were found with OP.
  
  
  CONCLUSIONS
  Percentage changes in SMRP levels, but not changes in OP levels, are a potentially useful marker of disease course. These findings should be validated prospectively for a role as an objective adjunctive measure of disease course in both clinical trials and clinical practice.
authors.affiliation: Princess Margaret Hospital, Toronto, Ontario, Canada.
authors.forename: Paul
authors.initials: P
authors.lastname: Wheatley-Price
authors.forename: Boming
authors.initials: B
authors.lastname: Yang
authors.forename: Demetris
authors.initials: D
authors.lastname: Patsios
authors.forename: Devalben
authors.initials: D
authors.lastname: Patel
authors.forename: Clement
authors.initials: C
authors.lastname: Ma
authors.forename: Wei
authors.initials: W
authors.lastname: Xu
authors.forename: Natasha
authors.initials: N
authors.lastname: Leighl
authors.forename: Ronald
authors.initials: R
authors.lastname: Feld
authors.forename: B C John
authors.initials: BC
authors.lastname: Cho
authors.forename: Brenda
authors.initials: B
authors.lastname: O'Sullivan
authors.forename: Heidi
authors.initials: H
authors.lastname: Roberts
authors.forename: Ming Sound
authors.initials: MS
authors.lastname: Tsao
authors.forename: Martin
authors.initials: M
authors.lastname: Tammemagi
authors.forename: Masaki
authors.initials: M
authors.lastname: Anraku
authors.forename: Zhuo
authors.initials: Z
authors.lastname: Chen
authors.forename: Marc
authors.initials: M
authors.lastname: de Perrot
authors.forename: Geoffrey
authors.initials: G
authors.lastname: Liu
mesh_terms: D014408:Biomarkers, Tumor / Q000097:blood; D005260:Female; D058851:GPI-Linked Proteins; D006801:Humans; D008297:Male; D008562:Membrane Glycoproteins / Q000097:blood*; D000090204:Mesothelin; D008654:Mesothelioma / Q000097:blood*; D053495:Osteopontin / Q000097:blood*; D010534:Peritoneal Neoplasms / Q000097:blood*; D010997:Pleural Neoplasms / Q000097:blood*; D011379:Prognosis; D016896:Treatment Outcome
chemical_list: D014408:Biomarkers, Tumor; D058851:GPI-Linked Proteins; D008562:Membrane Glycoproteins; D053495:Osteopontin; D000090204:Mesothelin