title: Fibulin-3 as a biomarker of response to treatment in malignant mesothelioma.
abstract: BACKGROUND
  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 within 18 months. The potential applicability of fibulin-3 in comparison with or in addition to soluble mesothelin-related peptides (SMRP) was also assessed.
  
  
  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 sub-types, tumour stages or the presence of metastatic disease. Significantly higher fibulin-3 levels were found in progressive disease as compared to the levels before treatment (Mann-Whitney [U] test = 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 within 18 months (odds ratio [OR] = 4.35, 95% confidence interval [CI] 1.56-12.13). Additionally, patients with fibulin-3 levels above 34.25 ng/ml after treatment with complete response or 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.
authors.affiliation: Institute of Oncology Ljubljana, Zaloška cesta 2, Ljubljana, Slovenia.
authors.forename: Viljem
authors.initials: V
authors.lastname: Kovac
authors.affiliation: Clinical Institute of Occupational Medicine, University Medical Center Ljubljana, Ljubljana, Slovenia.
authors.forename: Metoda
authors.initials: M
authors.lastname: Dodic-Fikfak
authors.affiliation: Clinical Institute of Occupational Medicine, University Medical Center Ljubljana, Ljubljana, Slovenia.
authors.forename: Niko
authors.initials: N
authors.lastname: Arneric
authors.affiliation: Pharmacogenetics Laboratory, Institute of Biochemistry, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.
authors.forename: Vita
authors.initials: V
authors.lastname: Dolzan
authors.affiliation: Clinical Institute of Occupational Medicine, University Medical Center Ljubljana, Ljubljana, Slovenia.
authors.forename: Alenka
authors.initials: A
authors.lastname: Franko
keywords: biomarker; fibulin-3; malignant mesothelioma; response to treatment