Mesothelioma Therapy Diagnosis and Biomarkers for Mesothelioma 3

Question 1

Which serum biomarker is most widely studied and used to monitor mesothelioma disease progression and treatment response?

Accepted Answer

Soluble mesothelin-related peptides (SMRP)

Answer

CA 19-9

Answer

CEA (carcinoembryonic antigen)

Answer

Alpha-fetoprotein (AFP)

Question 2

Approximately what is the sensitivity of serum soluble mesothelin-related peptides (SMRP) for diagnosing mesothelioma?

Accepted Answer

Approximately 50-70%

Answer

Approximately 20-30%

Answer

Greater than 90%

Answer

Nearly 100%

Question 3

Which biomarker has been found elevated in both plasma and pleural fluid of mesothelioma patients and proposed as an additional diagnostic marker?

Accepted Answer

Fibulin-3

Answer

Alpha-fetoprotein

Answer

PSA (prostate-specific antigen)

Answer

CA-125

Question 4

Why is BAP1 (BRCA1-associated protein 1) immunohistochemical testing clinically important in mesothelioma pathology?

Accepted Answer

Loss of BAP1 nuclear expression supports malignant mesothelioma over reactive mesothelial hyperplasia

Answer

It predicts response to platinum-based chemotherapy

Answer

It determines surgical resectability

Answer

It serves as a serum screening test for asbestos-exposed individuals

Question 5

What is the diagnostic significance of homozygous deletion of CDKN2A (p16) detected by fluorescence in situ hybridization (FISH) in pleural specimens?

Accepted Answer

It supports malignant mesothelioma over reactive mesothelial hyperplasia as a highly specific chromosomal marker

Answer

It is specific to sarcomatoid mesothelioma and has no diagnostic value in epithelioid subtype

Answer

It indicates resistance to pemetrexed-based chemotherapy

Answer

It is associated with a significantly better overall prognosis

Question 6

Which molecular testing approach has become increasingly important in mesothelioma to identify therapeutic targets and guide treatment?

Accepted Answer

Next-generation sequencing (NGS) for BAP1, NF2, and other recurrent tumor suppressor mutations

Answer

HER2 amplification testing by FISH

Answer

KRAS hotspot mutation testing alone

Answer

EGFR exon 19/21 deletion testing by PCR

Question 7

What is the therapeutic relevance of detecting NF2 (neurofibromatosis type 2) gene mutations in mesothelioma?

Accepted Answer

NF2 loss activates focal adhesion kinase (FAK) signaling, making these tumors potential candidates for FAK inhibitor therapy under investigation

Answer

It determines eligibility for extrapleural pneumonectomy

Answer

It predicts enhanced radiosensitivity and guides radiation dose escalation

Answer

It is used to screen first-degree relatives for hereditary mesothelioma risk