1. Serum Proteomics and Plasma Fibulin-3 in Differentiation of Mesothelioma From Asbestos-Exposed Controls and Patients With Other Pleural Diseases
- Author
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John G. Edwards, Matthew Neilson, Davand Sharma, Fiona T. Thomson, Carol McCormick, Caroline Kelly, Euan J. Cameron, Seamus Grundy, Stephen R. L. Clark, Samantha Hinsley, David Breen, Angela Wright, Dipak Mukherjee, Crispin J. Miller, Rachel Ostroff, Alan Hart-Thomas, J Holme, Mohammed Munavvar, Ioannis Psallidas, Giles Cox, Holly Hall, Rakesh Panchal, Nick A Maskell, Rehan Naseer, Matthew Evison, Leigh Alexander, Laura Alexander, Mahendran Chetty, Alina Ionescu, S. Tsim, Elankumaran Paramasivam, Kevin G. Blyth, Ann Shaw, Douglas Grieve, Anthony J. Chalmers, and C Daneshvar
- Subjects
Mesothelioma ,Proteomics ,0301 basic medicine ,Pulmonary and Respiratory Medicine ,Oncology ,medicine.medical_specialty ,Lung Neoplasms ,Pleural Neoplasms ,GPI-Linked Proteins ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Biomarkers, Tumor ,medicine ,Humans ,Mesothelin ,SOMAscan ,Retrospective Studies ,Extracellular Matrix Proteins ,biology ,business.industry ,Calcium-Binding Proteins ,Area under the curve ,Asbestos ,Retrospective cohort study ,Fibulin-3 ,Biomarker ,medicine.disease ,Primary tumor ,030104 developmental biology ,030220 oncology & carcinogenesis ,Cohort ,biology.protein ,Biomarker (medicine) ,Original Article ,Translational Oncology ,business ,Blood sampling - Abstract
Introduction:\ud Malignant pleural mesothelioma (MPM) is difficult to diagnose. An accurate blood biomarker could prompt specialist referral or be deployed in future screening. In earlier retrospective studies, SOMAscan proteomics (Somalogic, Boulder, CO) and fibulin-3 seemed highly accurate, but SOMAscan has not been validated prospectively and subsequent fibulin-3 data have been contradictory.\ud \ud Methods:\ud A multicenter prospective observational study was performed in 22 centers, generating a large intention-to-diagnose cohort. Blood sampling, processing, and diagnostic assessment were standardized, including a 1-year follow-up. Plasma fibulin-3 was measured using two enzyme-linked immunosorbent assays (CloudClone [used in previous studies] and BosterBio, Pleasanton, CA). Serum proteomics was measured using the SOMAscan assay. Diagnostic performance (sensitivity at 95% specificity, area under the curve [AUC]) was benchmarked against serum mesothelin (Mesomark, Fujirebio Diagnostics, Malvern, PA). Biomarkers were correlated against primary tumor volume, inflammatory markers, and asbestos exposure.\ud \ud Results:\ud A total of 638 patients with suspected pleural malignancy (SPM) and 110 asbestos-exposed controls (AECs) were recruited. SOMAscan reliably differentiated MPM from AECs (75% sensitivity, 88.2% specificity, validation cohort AUC 0.855) but was not useful in patients with differentiating non-MPM SPM. Fibulin-3 (by BosterBio after failed CloudClone validation) revealed 7.4% and 11.9% sensitivity at 95% specificity in MPM versus non-MPM SPM and AECs, respectively (associated AUCs 0.611 [0.557–0.664], p = 0.0015) and 0.516 [0.443–0.589], p = 0.671), both inferior to mesothelin. SOMAscan proteins correlated with inflammatory markers but not with asbestos exposure. Neither biomarker correlated with tumor volume.\ud \ud Conclusions:\ud SOMAscan may prove useful as a future screening test for MPM in asbestos-exposed persons. Neither fibulin-3 nor SOMAscan should be used for diagnosis or pathway stratification.
- Published
- 2021