title: Serum Survivin Levels and Outcome of Chemotherapy in Patients with Malignant Mesothelioma.
abstract: BACKGROUND
  Survivin is an inhibitor of apoptosis protein involved in the regulation of cell proliferation that could be used as a marker for cancer diagnosis or prognosis. Our aim was to evaluate whether serum survivin levels influence the outcome of cisplatin-based chemotherapy in patients with malignant mesothelioma (MM).
  
  
  METHODS
  Serum survivin levels were determined using human survivin enzyme-linked immunosorbent assay in 78 MM patients before chemotherapy, after chemotherapy, and at disease progression. The influence on tumor response and survival was evaluated using nonparametric tests and Cox regression.
  
  
  RESULTS
  A median serum survivin level at diagnosis was 4.1 (0-217.5) pg/mL. Patients with a progressive disease had significantly higher survivin levels before chemotherapy (p = 0.041). A median serum survivin level after chemotherapy was 73.1 (0-346.2) pg/mL. If survivin levels increased after chemotherapy, patients had, conversely, better response (p = 0.001, OR = 5.40, 95% CI = 1.98-14.72). Unexpectedly, patients with increased survivin levels after chemotherapy also had longer progression-free (p < 0.001, HR = 0.33, 95% CI = 0.20-0.57) and overall survival (p = 0.001, HR = 0.29, 95% CI = 0.14-0.58).
  
  
  CONCLUSIONS
  These results suggest that serum survivin levels before and during chemotherapy could serve as a biomarker predicting MM treatment response.
authors.affiliation: Pharmacogenetics Laboratory, Institute of Biochemistry, Faculty of Medicine, University of Ljubljana, SI-1000 Ljubljana, Slovenia.
authors.forename: Katja
authors.initials: K
authors.lastname: Goričar
authors.affiliation: Institute of Oncology Ljubljana, SI-1000 Ljubljana, Slovenia.
authors.forename: Viljem
authors.initials: V
authors.lastname: Kovač
authors.affiliation: Clinical Institute of Occupational Medicine, University Medical Center Ljubljana, SI-1000 Ljubljana, Slovenia.
authors.forename: Alenka
authors.initials: A
authors.lastname: Franko
authors.affiliation: Clinical Institute of Occupational Medicine, University Medical Center Ljubljana, SI-1000 Ljubljana, Slovenia.
authors.forename: Metoda
authors.initials: M
authors.lastname: Dodič-Fikfak
authors.affiliation: Pharmacogenetics Laboratory, Institute of Biochemistry, Faculty of Medicine, University of Ljubljana, SI-1000 Ljubljana, Slovenia.
authors.forename: Vita
authors.initials: V
authors.lastname: Dolžan
mesh_terms: D000368:Aged; D014408:Biomarkers, Tumor / Q000097:blood*; D005260:Female; D006801:Humans; D051034:Inhibitor of Apoptosis Proteins / Q000097:blood*; D008297:Male; D008654:Mesothelioma / Q000097:blood* / Q000188:drug therapy / Q000473:pathology; D008875:Middle Aged; D000077022:Survivin
chemical_list: C107489:BIRC5 protein, human; D014408:Biomarkers, Tumor; D051034:Inhibitor of Apoptosis Proteins; D000077022:Survivin