Doctors are constantly looking for indicators of mesothelioma survival. Stage, patient’s age, cell type and overall health are the most obvious ones.
Then there are protein biomarkers specific to long or short life expectancies.
Doctors found that two DNA repair biomarkers, ERCC1 and RRM1, indicate poorer prognosis and a need for “alternative” mesothelioma therapies. While this might seem like grim news, it’s better to know of the need for unorthodox treatment before attempting unhelpful options.
Using Genetic Biomarkers to Decide Treatment
Surgery, chemotherapy, radiation and immunotherapy are the four primary treatment options for mesothelioma. Surgery is the ideal choice, but not all people can have surgery. In some cases, the patient isn’t healthy enough. In others, the tumors have spread too far.
Chemotherapy, radiation and immunotherapy are the next choices. It’s best for unresectable cases to start these therapies immediately, before the disease reaches organs like the lungs.
The combination of ERCC1 and RRM1 may make this decision easier. Doctors can test for these biomarkers using immunohistochemical staining.
ERCC1 is the acronym for the gene “excision repair cross-complementing group 1” and RRM1 refers to “ribonucleotide reductase subunit M1.” Researchers intended to learn how often these genes are expressed within mesothelioma tumors and how they impact survival.
The study included 73 cases of malignant pleural mesothelioma, and more than half showed at least one of the two genes:
- 36 of 73 (49%) showed ERCC1
- 55 of 73 showed RRM1
- 34 of 73 showed both
- 23 of 73 showed just one
- 16 of 73 showed neither
Patients with both ERCC1 and RRM1 had much worse median survival: 6.6 months versus 13.8 months. Therefore, doctors suggest the combination “could define a group of patients with the worst prognosis who should need likely alternative treatment.”
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.
Sources & Author