The three most-common mesothelioma blood tests and biomarkers are: (WebMD.com)
- MESOMARK assay
- N-ERC/Mesothelin test
- Fibulin-3 test
- Megakaryocyte potentiation factor
Immunohistochemical markers are one type of complex lab studies that your doctor may use to accurately diagnose your mesothelioma. An accurate diagnosis is important so that your healthcare provider can offer the best treatment plan for your mesothelioma type.
How Mesothelioma Blood Tests Work
Blood tests for mesothelioma are effective because the biomarkers mentioned above are produced in tiny amounts or not at all by normal cells. This means the biomarkers are not usually present in a person who does not have mesothelioma.
For some mesothelioma tumors, the proteins are only for that specific cancer. Identifying each one suggests the patient has that type of mesothelioma.
Mesothelioma-specific biomarkers are often used for blood tests for the disease. They look for the presence of proteins that only a person with mesothelioma will produce.
What Are Other Uses for Mesothelioma Blood Tests?
Mesothelioma biomarkers are being studied for other vital purposes. They can not just help diagnose the disease; they can be used to treat some forms of mesothelioma. (mesotheliomagroup.com)
For instance, mesothelin is one of the biomarkers that mesothelioma makes. Clinical trials take out the patient’s immune cells, change them in the lab to target the mesothelin present in mesothelioma cells, and infuse them back into the body.
There were hopeful results presented about this approach at the 2019 American Society of Clinical Oncology Meeting. Eleven of 14 mesothelioma patients in the study had a complete response, partial response, or stable disease after a followup of approximately three years. (ASCOpubs.org)
An assay is a test that is performed in a laboratory. This assay measures the level of SMRP (serum-measured soluble mesothelin-related peptide) in the blood sample of the mesothelioma patient.
Some forms of asbestos cancer, such as sarcomatoid tumors, do not release much SMRP. That is why the FDA recommends that physicians use the MESOMARK assay with other blood tests to ensure an accurate diagnosis.
Some health insurance companies will not pay for this blood test. But if you or a loved one has a history of asbestos exposure and is at risk for mesothelioma, ask your physicians if this assay is a possibility.
Higher SMRP levels that the MESOMARK assay detects can help with first diagnosing mesothelioma. It sometimes will be used to check the cancer’s response to treatments. A declining biomarker can suggest the treatment is working.
One problem with this test is that cancers of the lung, pancreas and ovaries may also produce higher SMRP levels.
This test looks for a certain type of mesothelin called N-ERC/mesothelin. The assay is much like MESOMARK, but it uses a certain type of enzyme to look for a specific type of the mesothelin molecule. This boosts the accuracy of the assay.
The N-ERC/mesothelin test is up to 95% effective in finding mesothelioma. But it is only 75% effective at ruling out mesothelioma because the biomarker is made by other cancer types. (mesothelioma.com)
While it has more accuracy than MESOMARK, the -ERC-Mesothelin blood test cannot be used alone to diagnose asbestos cancer.
This is a protein that mesothelioma cells produce. It can be found in pleural fluid and blood. A mesothelioma expert named Harvey Pass, M.D., developed and validated this test for asbestos cancer diagnosis.
In 2012, Pass performed a study that showed that fibulin-3 is 97% effective in detecting mesothelioma, and 95% effective for ruling it out.
However, other clinical studies have found it to be less effective to find mesothelioma; it depends on when and how the test is used. For instance, when fibulin-3 is used on blood samples that were previously collected from mesothelioma patients, it did not have such a high level of accuracy.
A meta-analysis performed in 2019 found higher fibulin-3 blood levels in patients with mesothelioma than all control groups without the disease. This makes fibulin-3 a possibly useful blood test biomarker in those at a higher risk of developing mesothelioma.
Additional Blood Tests to Detect Mesothelioma
There are other mesothelioma biomarker tests to check for levels of osteopontin and megakaryocyte potentiation (MPF) factor in blood samples. Scientists have found that mesothelioma patients have more of these biomarkers in their blood than people with other cancers.
Osteopontin and MPF tests are not accurate enough to definitively diagnose mesothelioma. But they can play a major role in monitoring cancer after a diagnosis has been confirmed with CT scans, biopsies, and X-rays.
Human MPF Elisa Kit
This kit measures the presence of the megakaryocyte potentiation factor, which is a protein in mesothelin genes. Clinical studies have shown that higher MPF levels are detected in 90% of stage 3 and 4 mesothelioma patients and are not present in healthy patients. Doctors also use this test to check for cancer progression during treatment.
This is a biomarker that shows cell damage from oxidation. This biomarker can be present in blood samples when the cancer is first developing. Higher 80HdG levels may occur in people who were exposed to asbestos and could be developing asbestosis.
This biomarker can be made by many cancers, not just ones caused by asbestos exposure. Also, being exposed heavily to cigarette smoke and heavy metals can produce 80HdG.
Higher levels of the biomarker also are related to more serious cases of asbestosis. One clinical study found a combination of 80HdG, VEGbeta, and SMRPs can detect people with various levels of asbestos exposure.
Overall, some blood tests can be effective to diagnose mesothelioma, as well as the specific type and cell type. But blood tests must be used in combination with CT scans, biopsies, and X-rays to make a definitive mesothelioma diagnosis.
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