From the blog

Women with Pleural Mesothelioma Live Longer Compared to Men

Published: March 19, 2021

Mesothelioma is not found in as many women as men, but studies show that women can survive longer than men. Researchers at the International Mesothelioma Program at Brigham and Women’s Hospital in Boston found that a gene can help predict the prognosis and treatment outcome for women patients with mesothelioma. Researchers want to find therapies based on specific characteristics of tumors. The RAS-like estrogen-regulated growth inhibitor gene, or RERG gene, could be the reason that women diagnosed with mesothelioma live longer. Researchers found that women with a low RERG expression had a higher chance of death, so the RERG gene is tied to survival for women.

The study wants to see if estrogen-signaling genes will predict a mesothelioma patient’s survival. The number of men and women were balanced and other variables were controlled to ensure a valid study. Estrogen regulates reproductive processes and helps develop cardiovascular, bone, nervous, and immune systems. Estrogen receptor beta levels have been observed in mesothelioma patients in other studies as an indicator of survival. If researchers find more of the estrogen signaling genes, more treatments could be identified to help mesothelioma patients.

The researchers identified the RERG gene as a female specific biomarker that predicts mesothelioma prognosis. With breast cancer, people with high levels of the RERG protein had longer periods of time without disease spread. The study found that women mesothelioma patients with high levels of RERG had a median survival of 33.1 months versus women with low amounts of RERG having 15.9 months. This information is still in the early stages and more studies need to be done to confirm what researchers have found. Estrogen receptor expression was not found at the RNA or protein level in pleural mesothelioma tumors, however. The researchers also concluded that there was not an association between estradiol levels and survival and that RERG expression does not help predict survival in men.

A study from May 2020 found that women with pleural mesothelioma have a longer survival with 20.8 months versus 15.8 months for men. This can be for different reasons including women being diagnosed at a younger age from secondary asbestos exposure. When people are diagnosed at an earlier age, they have less comorbidities when they are diagnosed. Women also typically have epithelioid mesothelioma, which responds better to treatment compared to others. Being younger also allows women to be treated with more aggressive therapies. One type of therapy that people can receive is surgery, but women are 15 percent less likely to have it. Women are also 20 percent less likely to receive chemotherapy. If women undergo more aggressive therapies for mesothelioma, they could have a much better survival than men diagnosed with the same illness because they already have a better chance of survival from RERG gene expression.

Andrew R. Barsky et al., “Gender-based Disparities in Receipt of Care and Survival in Malignant Pleural Mesothelioma” Clinical Lung Cancer (November 1, 2020). [Link]
Assunta De Rienzo et al., ‘Association of RERG Expression with Female Survival Advantage in Malignant Pleural Mesothelioma” MDPI (February 2, 2021). [Link]
Assunta De Rienzo et al., “Gender-Specific Molecular and Clinical Features Underlie Malignant Pleural Mesothelioma” Molecular and Cellular Pathobiology (January 2016). [Link]
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