Fibrinogen Levels in the blood may act as Prognostic Indicator for MPM
By Kathy Cooke. 5th March 2014
A simple blood test may aid in helping decide if patient suffering from malignant pleural mesothelioma (MPM) will benefit from aggressive surgery.
Researchers from Austria, Hungary and Croatia reported their findings in the British Journal of Cancer last month and were encouraged by the results suggesting that fibrinogen could be a useful prognostic and predictive biomarker in MPM.
What is Fibrinogen?
Fibrinogen is a protein produced by the liver and aids in the blood clotting process to stop bleeding. A simple blood test can be done to tell how much fibrinogen a person has in their blood. The normal fibrinogen range is 200 - 400 milligrams per deciliter (mg/dL).
This study tested 176 patients with a mean age of 63.5 years who had been diagnosed with malignant pleural mesothelioma, the most common form of the disease.
Consistent with the demographics of mesothelioma there were more male than female cases - just under 4x men vs women.
The fibrinogen levels of these patients were taken just after the diagnosis of MPM prior to any treatment intervention.
The study reported that most of the patients (87.5%) tested had elevated levels of fibrinogen - >390 mg/dL.
On follow-up of the patients it was found that those who displayed lower levels of fibrinogen (627 mg /dL) had a longer average survival time (19.1 months) compared with those with high levels (8.5 months).
How can Fibrinogen Aid Mesothelioma Treatment Decisions?
The treatment for mesothelioma is complex and is usually multifaceted including surgery, chemotherapy and radiotherapy in some form. It can be quite debilitating and distressing for the patient and in some circumstances, given that the average mesothelioma patient does not survive beyond 1 year, it may not be considered of benefit to the patient if their remaining months are spent in hospital without any significant increase in survival. Currently there are few indicators to aid doctors in devising their treatment management plans for these patients as they are unsure who will benefit from a very radical approach to treatment.
In the study those patients who had surgery and were ranked in the top quarter for fibrinogen levels had an overall survival rate of 5.30 months. The remaining 3/4 with the lower fibrinogen levels who underwent surgery survived on average 31.3 months – a significant increase.
This simple blood test may aid doctors in choosing an appropriate treatment plan for the individual patient. The findings suggest that those patients with low fibrinogen levels may benefit from aggressive treatment including extrapleural pneumonectomy whilst those with high levels would benefit from a palliative treatment plan aimed at relieving symptoms only.
Study reference: B Ghanim, M A Hoda, T Klikovits, et al. Circulating fibrinogen is a prognostic and predictive biomarker in malignant pleural mesothelioma. British Journal of Cancer 110, 984-990 (18 February 2014) | doi:10.1038/bjc.2013.815
Kathy Cooke MA. BSc(Hons)
Cancer consultant and advisor
Kathy has worked in the cancer field for over 30 years. She was course leader for the MSc in Radiotherapy and Oncology at University of Hertfordshire. Then radiotherapy manager at the Cromwell Hospital in London and Partnership Quality Lead for Macmillan Cancer Support.. Read more >