Doctors are constantly looking for indicators of mesothelioma survival.
Stage, patient age, cell type, and overall health are the most common ones.
There are also protein biomarkers that can help predict long or short life expectancies.
Researchers found that two DNA repair biomarkers — ERCC1 and RRM1 — indicate poorer prognosis and a need for “alternative” mesothelioma therapies. While this may sound discouraging, it’s better for doctors to know which patients may not respond to conventional options before beginning treatment.
Using Genetic Biomarkers to Decide Treatment
Surgery, chemotherapy, radiation, and immunotherapy are the four primary treatment options for mesothelioma.
Surgery is ideal, but not all patients are candidates. Some may not be healthy enough, while others may have tumors that have spread too far.
For unresectable cases, chemotherapy, radiation, and immunotherapy become the main treatment choices. It’s best to begin these therapies immediately before the disease spreads to major organs like the lungs.
The combination of ERCC1 and RRM1 biomarkers may help doctors make these treatment decisions earlier. Testing for these biomarkers can be done through immunohistochemical staining.
ERCC1 stands for “excision repair cross-complementing group 1,” and RRM1 refers to “ribonucleotide reductase subunit M1.”
Researchers studied how often these genes are expressed within mesothelioma tumors and how their presence affects survival outcomes.
The study included 73 cases of malignant pleural mesothelioma. More than half of the cases showed at least one of the two biomarkers:
- 36 of 73 (49%) expressed ERCC1
- 55 of 73 expressed RRM1
- 34 of 73 expressed both
- 23 of 73 expressed just one
- 16 of 73 expressed neither
Patients with both ERCC1 and RRM1 expression had much worse median survival — 6.6 months versus 13.8 months.
Because of this, doctors suggest that the combination “could define a group of patients with the worst prognosis who should likely need alternative treatment approaches.”
Sources & Author
- Double-staining Immunohistochemistry Reveals in Malignant Pleural Mesothelioma the Coexpression of ERCC1 and RRM1 as a Frequent Biological Event Related to Poorer Survival. Applied Immunohistochemistry & Molecular Morphology. Retrieved from: https://pubmed.ncbi.nlm.nih.gov/32842027/. Accessed: 03/11/2021.
