Epidermal Growth Factor In Serum From Patients With Malignant Pleural Mesothelioma.

7315 Background: Diffuse malignant pleural mesothelioma (DMPM) is an aggressive and highly lethal tumor. Its incidence is increasing and is sensibly higher in some Italian areas, due to occupational and/or environmental exposure to asbestos. The epidermal growth factor (EGF) is a potent mitogen for human mesothelial and mesothelioma cells, and in addition it stimulates these cells to synthesize extracellular matrix proteins and induces a fibroblast-like morphology in their growth pattern, this phenotype worsening the biology of the tumor. Several preclinical studies have demonstrated that both EGF and EGF receptor are involved in the development and progression of DMPM. This pilot study was designed to assess the potential value of serum EGF measurement in the diagnosis and outcome of DMPM. METHODS Baseline serum EGF levels (ng/ml) were determined using an ELISA method in 20 newly diagnosed patients (mean age 67.4±9.1 years) and 17 age-gender matched healthy controls (HC; mean age 68.3±10.4 years). RESULTS Serum levels of EGF were twice those of HC (mean 1.1±0.4, range 0.7-2.1 vs 0.56±0.4, range 0.6±0.4; P<0.001). There was no difference in serum EGF concentration according to gender or tumor histology. The overall median survival in DMPM patients was 14 months. At univariate analysis, high EGF serum levels were associated with an unfavorable survival outcome. Using a cut-off point for EGF of 1.5 ng/ml (corresponding to the 80° percentile of marker concentration), the survival rate for patients with higher serum EGF was lower than that of patients with inferior levels (median 5.3 vs 14.0 months). CONCLUSIONS The mean serum concentration of EGF was doubled in DMPM with respect to controls, suggesting a possible diagnostic usefulness of this biomarker. High pre-treatment levels of EGF seem to be associated with an adverse impact on survival in patients with DMPM, although the data are not statistically significant. A larger series of DMPM patients is needed to confirm these results. No significant financial relationships to disclose.