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Karmanos' Dr. Harbut studies protein markers that could detect malignant mesothelioma

Michael Harbut, M.D., MPH., FCCP, director of the National Center for Vermiculite and Asbestos-Related Diseases and Environmental Cancer Program at the Barbara Ann Karmanos Cancer Center, has co-authored an investigational test based on a panel of 13 protein markers in the blood that may be able to detect malignant mesothelioma in people exposed to asbestos, even when the disease is in its earliest stages.
The study results were presented by Harvey I. Pass, M.D., a member of the Cardiothoracic Surgery Department in the division of Thoracic Surgery at Langone Medical Center and Cancer Center at New York University, at the most recent American Association for Cancer Research (AACR) annual meeting in Orlando.
To conduct the study, researchers used a technology that relies, in part, on DNA molecules called aptamers that bind to proteins in blood samples.
The study used a test developed by Colorado-based SomaLogic (which also funded the study). The test was used to analyze blood samples from 90 patients who had been exposed to asbestos and developed malignant mesothelioma and blood samples from 80 healthy participants who had been exposed to asbestos (control subjects).
The research team, led by Dr. Pass, used 75 percent of the samples to identify a panel of proteins that were routinely seen in blood samples from patients with mesothelioma but not in samples from the control subjects. Dr. Pass’ laboratory is supported by NCI’s Early Detection Research Network.
The biomarker panel in this “training set” had 80 percent sensitivity and 100 percent specificity for distinguishing between mesothelioma patients and control subjects and detected 15 of the 19 early-stage mesotheliomas. Similar results were seen in the remaining 25 percent of the samples, known as the validation set.
During a press briefing, Dr. Pass also presented data on the test’s performance in a different blinded validation set of samples from 38 patients with asbestos-related mesothelioma and 62 healthy asbestos-exposed control subjects. In this set, the marker panel had 92 percent specificity and 92 percent sensitivity.
In most patients with malignant mesothelioma, the disease is typically diagnosed at an advanced stage, when treatment has very limited success. For that reason, the ability to detect early-stage disease is important, “because these are the people with mesothelioma who will have long-term survival,” said Dr. Pass.
The current incidence of malignant mesothelioma is low: approximately 3,000 to 8,000 cases a year in the United States. However, an estimated 27.5 million people in the United States alone had occupational exposure to asbestos between 1940 and 1979, and because of its long latency period, the incidence of mesothelioma is not expected to peak for another 20 years.
Additional validation studies of the assay are being planned and more aptamers are being added to the test in an effort to improve its performance.
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