Mesothelioma Blood Tests and Biomarkers

What Are Mesothelioma Blood Tests?

Mesothelioma blood tests are procedures that use a small sample of your blood to check for signs of this rare cancer. During these procedures, a healthcare provider takes blood from your arm. A pathologist studies your blood in a laboratory for certain proteins and other changes that may appear if you have mesothelioma.

Doctors use these blood tests as a tool to learn more about your health. Results can help decide if you need more testing, help track your overall health or show how your body is responding to treatment. These tests support your care but don’t diagnose mesothelioma on their own.

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No blood test can detect asbestos exposure. Biopsy tests of tissues, however, can reveal the presence of asbestos fibers that can get stuck in tissues. Doctors often use biopsies to determine a diagnosis of mesothelioma.

How Do Mesothelioma Blood Tests Work?

Mesothelioma blood tests look for proteins in your blood that may be linked to this cancer. Patient Advocate Snehal Smart, MD of The Mesothelioma Center tells us, “There are no biomarkers specific to mesothelioma.” But some proteins like calretinin, WT-1 and mesothelin often appear at higher levels in people with mesothelioma.

One test called MESOMARK checks for specific protein molecules, called soluble mesothelin-related peptides. Snehal says SMRP is “usually high in patients with mesothelioma.” She explains that while the test alone can’t confirm the disease, “high levels of the SMRP protein can indicate a probable diagnosis of mesothelioma.” 

These blood tests can help doctors rule out other cancers or spot signs of mesothelioma early. You’ll still need other tests like biopsies and imaging scans for a diagnosis. Blood tests are just one part of the process doctors use to diagnose this disease.

Common Mesothelioma Blood Tests

The most common mesothelioma blood tests are MESOMARK, the mesothelin test and fibulin-3 tests. MESOMARK is the only FDA-approved blood test for mesothelioma. It looks for proteins the mesothelium, or lining around your body’s cavities, makes. The mesothelin test, also known as the N-ERC/mesothelin test, also looks for this protein. 

MESOMARK and the N-ERC/mesothelin test can usually indicate if mesothelioma is present. The fibulin-3 test can usually confirm when it’s not present. The fibulin-3 test is very specific. If fibulin-3 levels are low, there’s little chance of mesothelioma.

Blood Tests Commonly Used for Mesothelioma

Fibulin-3: Measures levels of the fibulin-3 protein. Higher levels are often found in people diagnosed with pleural mesothelioma.

HMGB1: Checks for a protein linked to inflammation. It can rise in people exposed to asbestos or diagnosed with mesothelioma.

MESOMARK: SMRP usually increases in people with mesothelioma. Sarcomatoid tumors, however, don’t release much SMRP. So the FDA advises doctors to use this test alongside other tests for a precise diagnosis.

N-ERC/Mesothelin: Measures specific parts of the mesothelin protein. It’s very sensitive but not specific. You may still have mesothelioma even if your N-ERC/mesothelin levels are low.

Osteopontin: Checks for osteopontin protein, which can be high in some people with mesothelioma. This test is less specific than the others.

All these blood tests use ELISA, a testing process that finds and measures certain proteins in the blood. A doctor or nurse takes a blood sample. That sample is mixed with antibodies that attach to the protein being tested. Machines then measure how much of the protein is there, helping doctors see what’s going on.

MESOMARK Assay

The MESOMARK test is most helpful for monitoring epithelioid and biphasic subtypes of mesothelioma. These are the most common subtypes of this malignant cancer. Healthy cells produce low SMRP levels, but so do some sarcomatoid mesothelioma tumors. So SMRP levels may stay low even if mesothelioma is present. 

According to Dr. Smart, “A MESOMARK blood test is performed by the physician or nurse practitioner drawing a sample of blood. That blood is sent to a lab where the levels of SMRP protein are measured.”

N-ERC/Mesothelin Test

Developed in Japan, the N-ERC/mesothelin test is a blood test for mesothelioma that identifies mesothelin in the bloodstream. Mesothelin is a protein released in the body as tumor cells grow. The test is currently undergoing trials for implementation worldwide.

Although other cancers can also release mesothelin, the N-ERC/mesothelin test is more accurate than MESOMARK. It can help diagnose mesothelioma faster compared to other blood tests, especially when paired with imaging and a thorough history.

Fibulin-3 Test

The Fibulin-3 blood test for mesothelioma evaluates the amount of fibulin-3 protein present. Research shows individuals diagnosed with pleural mesothelioma have increased average levels of fibulin-3. 

Several researchers have found the sensitivity of the fibulin-3 test can vary. This variation potentially makes the test less effective for detecting mesothelioma. But when paired with other tests, it can play a role in confirming a mesothelioma diagnosis or ruling out a diagnosis.

Emerging Biomarker-Based Blood Tests

Researchers continue to study new blood tests for mesothelioma to improve early detection and diagnosis. These tests aren’t yet widely available, but they show promise in identifying subtle signs of cancer.

New Blood Tests for Mesothelioma

• 8OHdG: This chemical shows DNA damage. It has a higher presence in people exposed to asbestos, helping identify those at risk for mesothelioma and other cancers.
• Calretinin: Levels of this protein are often high in mesothelioma, especially the epithelioid type. Combining it with mesothelin tests makes diagnosis more accurate.
• EGFR: Increased levels of this protein are common in mesothelioma and some lung cancers. New treatments targeting EGFR are being studied.
• Estrogen Receptor-β: Higher levels of these proteins that act as receptors for the estrogen hormone are seen in some mesothelioma cases.
• MPF: Elevated levels of this protein are linked to mesothelioma and can help monitor treatment, especially when combined with other tests.
• Osteopontin: This protein is higher in mesothelioma and other diseases, but it isn’t specific enough for diagnosis.

New studies suggest integrating multiple markers can improve accuracy and help tailor treatments. They’re also exploring additional signs or immunohistochemical markers of this disease. These advances and new, more effective combination tests will potentially enhance early detection and the outlook for people with this cancer or mesothelioma prognosis. 

For example, a 2023 study published in Journal of Thoracic Oncology explored how microRNA patterns may help detect mesothelioma in earlier stages. MicroRNA are tiny pieces inside your cells that help control which proteins your body makes. Research like this may eventually lead to more accurate and less invasive tests.

Common Questions About Mesothelioma Blood Tests

How accurate are mesothelioma blood tests compared to biopsies?

Blood tests for mesothelioma can provide helpful indications, but they’re not as conclusive as a biopsy. A biopsy remains the gold standard for diagnosis. 

Does insurance cover mesothelioma blood tests?

Insurance may cover some blood tests, like MESOMARK,with a prescription from a healthcare professional. But coverage varies widely depending on your insurance provider and policy specifics. 

Where can you have mesothelioma blood tests done?

Most mesothelioma blood tests are performed at specialized cancer centers, hospitals or laboratories that collaborate with mesothelioma experts. Patient Advocates or your doctor can help you find an appropriate facility for testing.

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