Predictive and Prognostic Biomarkers

**61**

and predictive factors.

**Chapter 5**

**Abstract**

**1. Introduction**

*Rodríguez-Cid Jeronimo Rafael* 

*and Flores-Mariñelarena Rodrigo Rafael*

Predictive and Prognosis Factors

of Clinical Utility in Mesothelioma

The constant research in therapeutics for mesothelioma has been improving their tumor response and overall survival, generating the need to propose markers that guide the doctor's therapeutic approach in a more precise way. Recently, different predictive factors have been proposed, such as mesothelin-related peptides, fibulin-3, and osteopontin associated with an image giving information about the probability of tumor response to a therapeutic agent or a combination of agents. As is well known, the importance of prognostic markers of utility lies in providing prospective information on the evolution of the patient and thus their ability to guide therapeutic decisions. Although the clinical stage and histology are currently the most described prognostic factors, recent studies have shown interest in the expression of estrogen receptor beta and calretinin, among other promising factors. Given the heterogeneity of this broad field of research in mesothelioma, it is necessary to objectively present the prognostic and predictive factors of greater clinical utility.

**Keywords:** prognosis factors, predictive factors, response to treatment, clinical

The prognosis of patients with mesothelioma is unfavorable, with a median survival of approximately 12 months from diagnosis [1–5]; this makes a clear need to improve the effectiveness of multimodality approaches and to define in a better way the subgroups' prognosis [6–9]. One way to achieve this objective is the use of prognostic and predictive factors; a prognostic factor provides prospective information on the evolution of the patient being able to guide therapeutic decisions, while a predictive factor gives us information on the probability of tumor response to a therapeutic agent. The characteristics that a prognostic factor must meet are: (a) simple prediction method, (b) wide availability, (c) sensitivity, and (d) reproducibility in any clinical situation. The purpose of these markers is to help define the individual prognosis of clinical groups, select patients who may need other treatments, and assign the most

Although currently the therapeutic decisions are still based on the classic clinical and pathological prognostic factors already known, such as age, functional status, sex, chest pain, weight loss, thrombocytosis, leukocytosis, anemia, and histological type [3, 10], biological and genetic factors may soon be excellent options as prognostic

factors, histopathology factors, biological factors, clinical scores

effective treatments to improve survival and quality of life.

## **Chapter 5**
