Tumor cells in pleural effusion and peripheral blood of malignant pleural mesothelioma patients

Malignant pleural mesothelioma (MPM) is an aggressive and treatment-resistant neoplasm that is often asbestosis-induced. Patients suffering from MPM often present with pleural effusions. Currently, no biomarker is available with an accuracy that is clinically acceptable to either confirm or
exclude the diagnosis malignant mesothelioma, based on pleural effusion cytology. Therefore, thoracoscopy is still the golden standard for diagnosing MPM. A thoracoscopy is an invasive procedure associated with morbidity (amongst which hospitalisation, pain, cardiac rhythm problems) and even with adequate tissue it can be difficult to conclusively identify MPM. We hypothesize that the use of a modified CellSearch enrichment method will specifically detect MPM tumor cells in the pleural effusion and peripheral blood of patients with MPM. By using this approach,
we aim to increase the sensitivity of fluid cytology of pleural effusion in MPM as well as to explore the use of circulating biomarkers in peripheral blood of MPM patients, thereby contributing to a better
diagnosis of MPM and hopefully a better outcome for patients.

We hypothesize that the use of a modified CellSearch enrichment method will specifically detect MPM tumor cells in the pleural effusion and peripheral blood of patients with MPM

Baseline: blood draw and pleural effusion punction

Follow-up: follow-up of overall survival up to 2.5 year following baseline

1) blood collection for circulating tumor cell enumeration, circulating endothelial cell enumeration and immune cell analysis

2) pleural effusion collection for pleural effusion tumor cell analysis

(NB these are not formal interventions, since they are being performed as a part of standard clinical practice)