Written by Joyce Smith, BS. This study demonstrates that serum survivin can function as a useful biomarker in the treatment of malignant mesothelioma.
Survivin is a member of a protein family that is involved in the regulation of both apoptosis (programmed cell death) and cell division. Survivin is also elevated in several kinds of cancers and is associated with chemotherapy resistance [1], increased tumor recurrence, and shorter patient survival. When survivin is inhibited, tumor cells can be sensitized to different chemotherapeutic agents including cisplatin [2] thus enhancing its effectiveness.
Cisplatin is used in the treatment of several types of cancer including malignant mesothelioma (MM) which is a rare and aggressive cancer with a poor prognosis and short survival. Recent MM studies have shown that although survivin levels were not associated with overall survival in MM [3], MM tumors that contained higher levels of survivin were more receptive to treatment. Survivin is present in both nuclei and cytoplasm of tumor cells and may play important roles in both inhibition of apoptosis (programmed cell death) and in regulation of mitosis (cell division) [4]. Thus the objective of this research was to evaluate whether serum survivin levels can influence the outcome of cisplatin-based chemotherapy in patients with (MM) and serve as useful biomarkers in the treatment of MM.
A total of 78 MM patients were included in this study. Pre and post treatment samples were obtained as well as serum samples at disease progression. Median follow up time was 25.2 months.
Researchers evaluated the serum survival levels in MM patients before and after cisplatin-based chemotherapy and at disease progression. The influence on tumor response and survival was also evaluated.
Results:
- A median serum survivin level at diagnosis was 4.1 (0–217.5) pg/mL.
- Patients with a progressive disease had significantly higher survivin levels before chemotherapy (p = 0.041).
- A median serum survivin level after chemotherapy was 73.1 (0–346.2) pg/mL.
- Patients with higher survivin levels before chemotherapy tended to have a worse treatment outcome; however, patients with increased survivin levels after chemotherapy not only had a better response (p = 0.001) but also had a longer progression free survival (PFS) and overall survival (OS).
These changes in serum survivin during treatment demonstrate that increased survivin levels following chemotherapy are a marker of a better treatment outcome for those with malignant mesothelioma. Researchers believe that based on the results of this study, monitoring this noninvasive biomarker could potentially contribute to a better treatment response. Thus they emphasize the importance of measuring serum survivin levels both before and after chemotherapy.
*Prescription drugs can save lives but may also cause unwanted side effects. Thus not all drugs are considered safe. Consult with your medical healthcare provider for more information on a specific drug of interest.
Source: GoriIar et al.Serum Survivin Levels and Outcome of Chemotherapy in Patients with Malignant MesotheliomaDisease Markers Volume 2015, Article ID 316739, 8 pages http://dx.doi.org/10.1155/2015/316739
© 2015 Katja Goriˇcar et al. This is an open access article distributed under the Creative Commons Attribution License,
Click here to read the full text study.
Posted November 11, 2015.
References:
- Mita, A.C., et al., Survivin: key regulator of mitosis and apoptosis and novel target for cancer therapeutics. Clinical Cancer Research, 2008. 14(16): p. 5000-5005.
- Zaffaroni, N. and M.G. Daidone, Survivin expression and resistance to anticancer treatments: perspectives for new therapeutic interventions. Drug resistance updates, 2002. 5(2): p. 65-72.
- Hmeljak, J., et al., BIRC5 promoter SNPs do not affect nuclear survivin expression and survival of malignant pleural mesothelioma patients. Journal of cancer research and clinical oncology, 2011. 137(11): p. 1641-1651.
- Hmeljak, J., et al., Is survivin expression prognostic or predictive in malignant pleural mesothelioma? Virchows Archiv, 2013. 462(3): p. 315-321.
