الفهرس 
EpidemiologyOnly 14 pages are availabe for public view
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Abstract
In malignant pleura mesothelioma (MPM), radiologic assessment of disease status is confusing soluble mesothelin-related peptide (SMRP) has utility in distinguishing MPM from benign pleural disease. We evaluated SMRP as predictive marker in relation to the disease course of MPM.
Patients and Methods: Serial plasma samples from patients with unresectable stage IV MPM were prospectively collected before starting and after finishing 3 cycles of platinum-based pemetrexed regimen. SMRP levels were measured. Radiologic assessment by modified resist criteria across time showing disease progression, stability, or shrinkage were compared with corresponding changes in SMRP levels.
Results: from 40 patients (female: 16; male: 24), 80 samples were collected. At study entry, all patients had measurable disease and SMRP level in 40 patients showed that the median SMRP was 0.32 ng/ml (IQR = 0.25-1.01) before chemotherapy) and the median SMRP was 0.29 ng/ml (IQR = 0.2-0.86) after 3 cycle chemotherapy. Percentage change in SMRP more than 10% correlated with the radiologic assessment (P .001) by modified RECIST (P.001). SMRP level of all partial response group decreased ≥ 10% from baseline level and SMRP level of all progressive decease group increased ≥ 10% from baseline level. No significant difference was observed between the absolute difference of SMRP and different response groups (p 0.227). In addition, Percentage change in SMRP had a significant effect on both OS (p 0.013) and PFS (p 0.023).
Conclusion: Percentage changes rather than absolute change of SMRP levels, are a potentially useful predictive marker of disease course. These findings should be validated prospectively for a role as an objective adjunctive measure of disease course in both clinical trials and clinical practice.