Introduction: Malignant Pleural Mesothelioma (MPM) is a rare and aggressive disease with limited treatment options and a poor prognosis.

Patients and Methods: Patients typically present with pleural effusion, dyspnea, and chest pain. The initial diagnostic procedures include chest X-ray, CT scans, and pleural fluid cytology. MPM is usually diagnosed at an advanced stage. Mesothelin levels were evaluated. Patients included 2 control groups: healthy individuals (n = 355) and oil refinery workers (n = 283), compared to acute MPM (n = 135): mild mesothelin levels (1.5–40 nm, n = 63) and very high mesothelin levels (40–201 nm, n = 72). Mesothelin levels were measured using Fujirebio Diagnostics kits (Malvern, PA), which were FDAapproved for mesothelioma monitoring in 2007. VEGF and IL-6 levels were also assessed using kits of R&D Systems.

Results: The results demonstrate a clear correlation between MPM and significantly elevated mesothelin levels compared to the control groups. A significant decrease in mesothelin levels was observed in patients who responded to treatment over three and six months, while non-responders exhibited increasing mesothelin levels. Rising mesothelin levels were associated with disease recurrence. Parallel biomarker trends were observed: IL-6 and VEGF levels showed a similar pattern.

Conclusions: We have shown that mesothelin is the best tumor marker for MPM, indicating response to therapy, enabling early detection of recurrence and allowing immediate therapy to improve survival.